Alistair Darling: I agree. Many people enjoy a drink on the train services between Scotland and England, as they do on aeroplanes. As I said, the Government have absolutely no plans to change the law in that regard, nor have they any plans to change the law with regard to the consumption of alcohol on trains generally in England—in other words, on the non cross-border services. There are no plans to change the law at all.

Anne McIntosh: Is the Minister aware of the serious situation arising from the fact that the permanent regulations on Scottish legal aid have not yet been passed by the Scottish Legal Aid Board and the Scottish Executive, which has the impact that many counsel have to withdraw from representing clients, especially in appeal cases? Not only are their expenses not being met, but it is costing them money to represent clients in those circumstances. Will the Minister make urgent representations to the Advocate-General, the Lord Advocate and the Executive to ensure that those regulations, which were due to be adopted in September, will be passed at the earliest opportunity?

Alex Salmond: What advice was sought or given by the Advocate-General on the question of the Government's terrorism legislation? We know that the Home Secretary, in an arrogant and dismissive attitude to Scots law, did not seek the advice of the Lord Advocate and we know that, in a craven way, neither the Lord Advocate nor the First Minister offered advice. The Advocate-General has a role in those matters, so will the Minister tell us whether she was treated in the same dismissive and contemptuous way?

Alistair Carmichael: Surely the Advocate-General should at least have suggested to the Home Secretary that he speak to the Lord Advocate about those matters. Is not it the case that the embarrassment now shared by the Home Secretary and the Lord Advocate, because of the failure to consult, is the responsibility of the Advocate-General?

Alistair Darling: The hon. Gentleman is right to suggest that smoking damages people's health no matter where they smoke. However, health is devolved to the Scottish Parliament, so it is entirely up to it to take a different view from the legislation that applies to England. The experience internationally—for example, in New York and Dublin—is that the ban has not been damaging in the way that its opponents have feared. Indeed, many people enjoy the opportunity to go out to a place where they will not breathe in other people's smoke.

Alistair Darling: On the targets, the hon. Gentleman and the House will be aware that the Government are reviewing our policies at the moment, because it is important that the targets that we set ourselves are met. Indeed, we have done many things over the past two or three years. For example, last week, I announced proposals on biofuels that would involve taking about 1 million tonnes of carbon from the atmosphere. That is equivalent to taking more than 1 million cars off the roads every year.
	On nuclear power, the Prime Minister has made it clear that part of our energy review will include whether we either extend the lives of the present nuclear generating plants or build new plants. The decisions on extending the lives of the existing nuclear plants must be taken in the next few years, first in relation to Hunterston and then Torness. Of course, as part of the review, we will decide whether or not new nuclear plants will be needed in the future.

Alistair Darling: I agree with my hon. Friend's suggestion that it is important to do everything that we can to extend the amount of power that is generated by wind and other renewable sources. It is unfortunate, however, that many people who call for an extension of renewable power set about opposing the very means to deliver it—both the generators themselves and the power lines needed to carry the electricity. I agree that it is very important for both Scotland the UK that we generate as much renewable energy as possible.

Alistair Darling: The hon. Gentleman will know that my hon. Friend the Minister for Energy said on Friday that the Government intended to extend powers under section 185 so that an advantage could be given to the generation of electricity on the islands. Examining that will be well worthwhile.
	I assume that the proposal would apply to Thurso. I understand that the hon. Gentleman owns a large amount of water in the north of Scotland, if not all of it—I declare an interest for him since he forgot to do that. I shall have a word with my hon. Friend the Minister for Energy to determine whether anything can be done. The hon. Gentleman is right that electricity can be generated on a small and local basis. Indeed, that is one of the things that my hon. Friend the Member for Edinburgh, North and Leith (Mark Lazarowicz) wants to encourage. My hon. Friend's Bill received its Second Reading on Friday, so I hope that that will encourage such activity.

John Robertson: I thank my hon. Friend for his reply. He will be aware of the by-election held in my constituency in Knightswood Park last week, where Labour received 55 per cent. of the vote. One of the main issues on the doorstep was the effect that drugs are having on the community.—[Interruption.] That is obviously not important to Opposition Members. I draw my hon. Friend's attention to the recent article in the Sunday Mail about the Daniels family, who amassed more than £16 million through drug peddling. Will he continue to work closely with the Scottish Executive to find solutions to prevent the misery and havoc that the drug culture wreaks on our communities, and will he do something about these parasites?

David Cairns: Every hon. Member is aware of the scourge of drug consumption—it ruins the lives of addicts, the lives of their families and the lives of those who have to live among people who deal in drugs. The Scottish Drug Enforcement Agency has had some considerable success. In the first six months of 2004–05, it seized more class A drugs than during the whole of the preceding 12 months, and so far this year it has seized class A drugs of a potential street value of more than £22 million.
	My hon. Friend rightly highlights the work of the Assets Recovery Agency, which takes away the assets of those suspected of drug dealing. We cannot come down too hard on these people because they ruin lives and they ruin communities.

Employment Statistics

Alistair Darling: On full employment, I have just told my hon. Friend the Member for Livingston (Mr. Devine) that measures such as the new deal, which the Liberals opposed—to be fair, they were in favour of the concept, but against its funding—mean that hundreds of thousands of people are now in work and doing well in employment. That would never have happened but for the Government's policies. As for the North sea oil sector, it is doing well at the moment. Over the past 20 to 30 years, there have been many changes in the regime governing taxation, but I am confident that the Government will do everything that they possibly can to make sure that the North sea oil industry continues to develop and expand, as that is extremely important, particularly for the economy of north-east Scotland.

Harriet Harman: The hon. Gentleman refers to the comments of Richard Mawrey QC following his electoral court investigation into local government matters in Birmingham. We have gone through that judgment very carefully indeed. The 10 measures to increase security in elections that we have included in primary legislation, in the Electoral Administration Bill which is before the House, and the four measures that will be in secondary legislation arise from that judgment, so we have taken it on board and introduced primary and secondary legislation to address it. We will pilot individual identifiers because we want to test whether the increase in security that can come from stricter requirements as a condition of being on the register are not outweighed by a fall in registration. I have taken the opportunity of looking at the South-West Bedfordshire register. There is not a problem of under-registration there. The hon. Gentleman should be careful before he makes suggestions that would not be a problem on the register of electors in his area, but which might have catastrophic effects in areas where there is a shortage on the electoral register.

Harriet Harman: My hon. Friend has made a good point, which is that even where electoral registration officers use data checking to discover whether somebody is actually present at an address in order to fill a gap in the register, they do not have the power to put them on the register and must still obtain a signature. He is right on that point, but it is still helpful when electoral registration officers check whether someone is present at an address. The Electoral Administration Bill requires electoral registration officers to use the available data, which some of them have not been doing. On fraud and data sharing, data matching and data checking mean that electoral registration officers can use existing data not only to ensure that gaps in the register are filled, but to check against fraud.

Harriet Harman: I am not kicking it into the long grass—I am proceeding by way of pilots so that we can have an evidence-based approach to policymaking. The hon. Gentleman implies that we are doing this too late. I shall not comment on that.
	As the hon. Gentleman says, it is important that we have an accurate register as proof against fraud; that is why we have introduced 10 measures in primary legislation and four in secondary legislation. We need to have it as proof against inadvertent inaccuracies; that is why we will have a central online record of electors and use data sharing. It is important not to be absolutist and ideological about this.
	Hon. Members on both sides of the House must surely agree that measures against fraud should be as tough as possible and that everybody who is eligible should be on the register. I hope that they accept that that is what, in good faith, my Department, my fellow Ministers and I are trying to do.

David Heath: Does the Minister accept that the experiment in Vauxhall in north Liverpool and the future one in Salford are enormously to be welcomed? Does she also accept—as I think she does, given what she said about evaluation—that the social and legal environment in the Red Hook area in New York, which was the origin of the experiment, is very different from that in northern Britain, let alone Wales, and that we need to look very carefully at whether they work?
	One could say that the old-fashioned term for community justice centres is magistrates courts. Does the Minister agree that we need to ensure that every community in England and Wales has access to a magistrates court? Will she make it clear that the further proposals for rationalisation or closure of local magistrates courts play no part in providing a community justice system?

Harriet Harman: In the past five years, including the current one, the Conservative party will have received approximately £22.5 million in Short money, Cranborne money, and policy development grants. That figure does not include free postage and party political broadcasts.

Gwyneth Dunwoody: Will my hon. Friend carefully consider whether sufficient hours are allowed for private Members' Bills during the parliamentary week? There are ways in which the term could be extended. Private Members frequently come up with sensible ideas that ought to be allowed on to the statute book, but which are rejected by the Government of the day—sometimes for rather lightweight reasons.

Nigel Griffiths: There are 13 sitting Fridays for such Bills to be considered. The whole House will endorse my hon. Friend's sentiments in promoting the right of private Members to have their Bills debated. When I have attended on Fridays, I have seen that there appears to be ample opportunity for debate, although, for one reason or another, best advantage is sometimes not taken of it. As I said, the Modernisation Committee considered this matter recently, as did the House in deciding our sitting patterns. I know that the House will want to review that matter from time to time as appropriate.

Peter Bone: I thank the hon. Gentleman for that reply. Should not we give a lead to the nation over fair trade products, which are very good? Surely the number of fair trade products available in the House is rather paltry, and should not we have a target for the availability of such products in the House?

Helen Southworth: I beg to move,
	That leave be given to bring in a Bill to make provision for a national system to safeguard runaway and missing children; to make provision for the collection and reporting of information about runaway and missing children; make provision for co-ordination between local authorities and other bodies; and for connected purposes.
	Children who run away or go missing from home are not bad children; they are children in a bad situation, at very real risk of danger. They need us to act together to help sort out their problems and keep them safe. We know the high risk that lone children face, yet we do not know how many children are reported missing to the police nationally, where they are missing or where they go. We do not have the information that we need to direct resources to deal with a critical and very complex issue.
	The most comprehensive information that we have is from studies conducted by the Children's Society and the National Missing Persons Helpline, both of which are charities. The Children's Society undertook a new national survey of young people in the first half of 2005, involving more than 11,000 young people aged between 14 and 16 in mainstream schools, special schools and pupil referral units in 25 areas of England. The findings were stark. An estimated 100,000 young people under 16 run away or are forced to leave home to escape problems, while 77,000 children are running away for the first time each year.
	The reasons for leaving home or care are very varied. Some young people are testing the boundaries, or find it difficult to negotiate and resolve difficulties in their families. Some have experienced bullying and a high level of conflict. Some are escaping abuse, neglect and danger. A quarter of young runaways said that they were forced to leave home and two thirds of children running away overnight were not reported missing to the police on the most recent occasion of going missing. Those findings are consistent with a smaller study conducted by the Children's Society in South Yorkshire and with evidence taken from the United States.
	One in six runaways slept rough while they were away. If extrapolated, that means more than 10,000 children aged between 14 and 16 are sleeping rough every year in England alone. The risk of being hurt or harmed increases with the time spent away from home. Children who were away for a week or more were twice as likely to have been harmed as those away for just one night. Only a fifth of children sought help from anyone while away from home.
	The university of York studied children who had used Message Home—the National Missing Persons Helpline 24-hour service—and found that while four fifths of those questioned had run away, one fifth reported that they had been forced to leave. The majority had gone missing from their family home, with a quarter reporting abuse and nearly a tenth bullying or other school problems. Many of those who had run away had stayed in very risky environments. Almost a third had stayed with a stranger, and more than two fifths had slept rough.
	In the York study, one in eight reported having been physically hurt and one in nine reported having been sexually assaulted while away. Young people reported feeling unsafe or frightened while staying with strangers. Some stayed with adults whom they thought were friends only to be subject to abuse and placed at risk. The report concluded:
	"It is difficult to over estimate the degree to which young people are vulnerable to exploitation when they are away from safe adult care".
	Some young people have horrifying and very dangerous experiences that would test the courage and resilience of anyone in this Chamber—and the impact can be felt for many years.
	Crisis, the charity for single homeless people, argues that research shows that children who run away are more likely to become homeless in later life. Crisis believes that it is important to intervene as early as possible to prevent runaway children from settling into a homeless lifestyle. The circumstances in which young people run away or are missing from home or care can be distressing, frightening and dangerous. It is difficult for the police and local authorities to predict the risk in individual cases.
	Huge improvements have taken place in children's services since the Children's Society set up the first UK refuge for runaway children in 1985. The social exclusion unit reported on young runaways in November 2002 and the Department of Health statutory guidance issued at the same time places requirements on local authorities to establish joint protocols to co-ordinate joint working across all agencies—including police, social services and health—for children who go missing. Each authority must have a senior manager to oversee those protocols and their implementation, and must produce an annual strategic monitoring report.
	Part of the complexity of supporting children who have run away or are missing from home is that many children do not stay close to home. In my constituency, for example, they could be in the major cities of Liverpool or Manchester within 40 minutes of leaving home, crossing several local authority and police boundaries in the process. Police boundaries are rarely coterminous with those of local authorities.
	The Association of Chief Police Officers has published guidance this year on the management, recording and investigation of missing persons, with standardised data collection requirements and case management procedures. For the first time, there are national standards to work to and forces can be inspected on them. However, the guidance does not yet have the status of a code of practice, and does not yet have the IT infrastructure to underpin the reporting requirement. Indeed, some police forces are still using paper-based systems, making information sharing very labour intensive. ACPO has developed protocols and IT systems with the National Missing Persons Helpline and the Home Office has agreed to make the IT systems available to forces at cost.
	The Bill will establish a requirement for a single comprehensive national database and for the reporting of information to enable effective planning, to identify trends and to inform service commissioning and the sharing of best practice. There is no national co-ordination in place for providing services to young runaways—despite the very clear fact that running away is an act that can take children and young people across local authority and police boundaries and right across the country. The UK Police National Missing Persons Bureau, which conducted a strategic review earlier this year, could play a key role in managing data, running briefs and debriefs on critical incidents, and providing information for the commissioning of local and strategic services. But it needs a clear remit, and to be properly resourced as part of a national strategy.
	Voluntary organisations are providing very important support services for vulnerable children, some of whom do not relate to, or feel intimidated by, statutory services. Some of these organisations are strategic service providers such as the Children's Society and the National Missing Persons Helpline, but a wide range of charities and non-governmental organisations also play a vital role supporting runaway and missing children and young people. In my constituency, "Talk Don't Walk"—a new, local charity-managed joint partnership project with the police, the local authority, health services, Connexions and the voluntary sector—is having a significant impact on reducing incidents of running away. Early this year, it worked with children in local authority care and their care staff to deal with issues of concern to them, and to prevent them from needing to push the boundaries by running away. The number of runaway incidents was cut from 83 to 39, and overnight episodes were cut from 67 to just one. On the basis of Home Office figures, which state that an overnight episode costs more than £1,400 on average, the total saving in terms of service resources was in excess of £78,000, but the saving in anxiety, risk and danger to those young people was far greater.
	There are a significant number of local and national agencies and departments whose activities and responsibilities need to be brought together to support vulnerable children who are susceptible to running away. Advice and counselling, and help with negotiating boundaries and managing relationships, could assist such young people in finding alternative strategies to deal with problems at home and in school.
	We need a national overview of projects working with missing children, so that we can learn what works best and roll out best practice. We also need a strategic body to commission or purchase cross-boundary services such as a nationally accessible 24-hour helpline; an appropriate number of children's refuges; and safe, supported accommodation. The National Missing Persons Helpline is dependent on donations, grants, charity shops and volunteers for its survival. The Children's Society's "safe and sound" campaign has highlighted the fact that there are only three children's refuges in the UK, offering a total of just 10 beds. Moreover, Government funding for the two runaway refuges in England will end in March 2006.
	This Bill will establish a requirement for the national collection and reporting of data on children reported missing to the police, and a requirement for a regular national survey of young people similar to the British crime survey, in order to identify under-reporting. With co-ordinated leadership from national Government, it will also establish a national co-ordinating body that will include key statutory and voluntary agencies, in order to develop integrated policy and service provision.
	We need to do this to protect vulnerable children, and I commend the Bill to the House.
	Question put and agreed to.
	Bill ordered to be brought in by Helen Southworth, John Battle, Ann Keen, Rosemary McKenna, Liz Blackman, Dan Norris, Ms Dari Taylor, Paddy Tipping, Laura Moffatt, Kitty Ussher, Peter Bottomley and Mr. Paul Burstow.

Tim Yeo: Is my hon. Friend aware that Suffolk West primary care trust proposes savage cuts in my constituency, including the closure of Walnut Tree and St. Leonard's hospitals in Sudbury with the loss of 68 beds? The cuts will be made at time when Suffolk county council's social care budget is under extreme pressure and facing cuts, the population of the town is increasing sharply and beds in West Suffolk hospital—the district hospital that serves the area—are also being cut. The PCT's announcement of the cuts came just three months after it had approved the construction of a new replacement community hospital in Sudbury, the announcement of which came—conveniently—just before the general election. Today, Sudbury's existing hospital is to be closed, its new hospital has been cancelled and no replacement community services will be in existence before the cuts are made.

Gregory Barker: My hon. Friend may be interested to know that patients are already paying a price in East Sussex. In the East Sussex Hospitals NHS Trust, which is almost £5 million in deficit, not only two weeks ago did Conquest hospital start closing wards ahead of the winter, but it has now told all new out-patients that no one will be seen this side of Christmas and that patients must travel up to 30 miles. That is a damning indictment of not just the current financial crisis but a health funding formula that diverts funds away from constituencies such as mine in the south-east to Labour's friends in the north.

Andrew Lansley: Yes. I did indeed visit Tetbury hospital in my hon. Friend's constituency. Given the valuable work done there and the opportunity for patients to be sent closer to home for further rehabilitation after operations, in refurbished and well-appointed small wards, I was astonished that the PCT proposes to close them at the end of December. That seems outrageous and he was right to receive a substantial local petition on the subject.
	I want to pick up the thread of where we are with the number of beds. Our analysis—clearly, the figure is greater than we knew—is that 2,500 additional NHS beds are threatened with closure this year in the 43 trusts that we identified from our survey. In the five years since the publication of the NHS plan, instead of 7,000 more hospital beds, there will be 7,000 fewer. Five years ago, we had 186,000 beds in the NHS and 159,000 administrators. By the end of this year, we will have fewer than 180,000 NHS beds, yet more than 211,000 administrators.
	What has been going on? Why have these deficits occurred? It is partly because the Government have been decreeing the cost structure of the NHS and costs have been rising dramatically. Something like 80 per cent. of the additional cash provided for the NHS has been consumed by spending pressures: pensions indexation; National Institute for Health and Clinical Excellence guidelines; the consultants' contract, the cost of which the Government underestimated; the general practitioner contract, the cost of which was substantially underestimated; the drugs bill; and the implications of the working time directive, which means that many more medical staff must be employed to undertake the same work as previously. Additionally, £500 million extra has been spent on "Agenda for Change" and information technology costs have been higher than predicted. I am reliably informed that, if the NHS tariff had had to incorporate all the additional spending pressures last year, it would have increased by more than 8 per cent. All the extra cash thus would not have bought anything extra, which is interesting because that is precisely what happened. We had all the extra cash, but there was no increase whatsoever in the number of elective operations—that is, planned operations—carried out in NHS hospitals between 2003–04 and 2004–05.

Patricia Hewitt: My hon. Friend makes an important point. [Interruption.] One estimate of the impact of taking out the £1 billion to £2 billion that the Opposition promised—or should I say threatened—at the general election to invest in their patient's passport would be a reduction by 9,000 consultants in the staff of the NHS, a massive reduction in care for the NHS patients and a devastation of the NHS right across the country. [Interruption.]

Jim Cunningham: Earlier, my right hon. Friend said that she would get a reply to the letter that I sent to the University Hospitals Coventry and Warwickshire NHS Trust. Will she also look into the reason why there is a £7 million deficit and a threat to 250 jobs there? I would appreciate it if she could do that for me.

Patricia Hewitt: As I was saying, the reason why there are deficits in a minority of trusts is that, in some cases, there has been overspending, sometimes for several years, or poor financial management, or poor organisation of clinical services. We are taking the steps needed to reduce the overall deficit this year and to ensure that, at the end of the next financial year, the NHS will again be in balance.

Sandra Gidley: I am pleased to debate this subject today, and I am delighted that the Conservatives have made it clear that they are committed to the provision of
	"comprehensive, high quality health services, based on need and not ability to pay".
	There has been some doubt about that in the past—a doubt that was echoed by Labour Members when they queried the Conservatives' reluctance to commit to funding the health service, and their voting against the £8 billion funding increase associated with the increase in national insurance levels. However, the most important matter before us today is to examine Labour's record after eight years in government, and to consider why, despite record levels of investment, many local health services are lurching from crisis to crisis, like a drunk on a Saturday night who grabs at anything in an attempt to stay upright.
	I shall return to the question of the deficit shortly, but at this point I want to be fair and to acknowledge that some things have got better. When I was first elected in 2000, my postbag was full of letters from constituents who had been waiting years for hip replacements or hearing aids, or waiting months for heart operations classified as urgent. Such problems have been sorted out to an extent, but others are emerging in our local health services. I suspect that my experience is similar to that of many Members, in that today's issues for my constituents are the rationing of certain treatments and medicines, fear of MRSA, and the reorganisation of local health services. In an unprecedented development, NHS staff are writing letters to whistleblow on changes that they are particularly unhappy with. Such changes often mean a relocation of health services or a loss of hospital beds.

Sandra Gidley: We could probably have a separate debate on the special factors that could be taken into account in the funding formula, but I take my hon. Friend's point.
	Twelve NHS trusts reported a deficit of more than £5 million in 2003–04. The King's Fund has pointed out that NHS productivity has fallen, according to the official measure, but it also acknowledges that that is not necessarily a measure of quality. How should we measure quality in the NHS? In recent years, we had the star ratings—now largely discredited—and the trusts learnt to play the game. Resources were put into areas that had targets associated with star ratings. Not only did that sometimes cause trusts to spend money that they could ill afford, but health services not associated with the targets became easy options for savings.
	A particular example of that tendency is the specialist services, such as renal and dialysis services, which are especially vulnerable. They are expensive and affect relatively few patients, and the same provider often services several PCTs. They are easy targets but patients diagnosed with one of the specialist diseases—there are 34, but I shall not list them all—should not suffer as a result of the historical financial health of local NHS organisations. When payment by results is introduced, some of those existing inequalities could be exacerbated.
	It would be bad enough if that were the whole story. However, the British Medical Association has pointed out that cash shortages in the NHS contrast dramatically with the generous terms negotiated with some private sector providers—as Conservative Members have pointed out. The BMA makes the point that it is cause for even greater concern when the contracts agreed with such companies allow payments to continue, despite significant underperformance. Examples include the orthopaedic contracts in south Yorkshire and Trent and some MRI and eye contracts. It would be useful if the Secretary of State could explain what sanctions are in place for when private providers do not deliver the services for which they are contracted.
	In many cases, the cuts have taken place with little or no clinical engagement and—unfortunately—even less public engagement. In September, the BMA conducted a survey of trusts that revealed that one in three planned to reduce services. Intended reductions included bed closures, staff redundancies and a freeze on recruitment, reduced elective services, ward closures, cuts in training and a reduction in patient transport services. Three quarters of respondents reported that their trust faced a financial shortfall in the current financial year and more than a third reported that funding agreements with PCTs had been changed at short notice.
	The Government cannot have it all ways. Financial instability is an inevitable consequence of reintroducing the internal market. In any market, there are winners and losers and rushed reforms tend to exacerbate existing inequalities. Does the Secretary of State think it wise to introduce a system that sets hospitals against each other, rather than encouraging them to work as partners in providing the best possible overall service for patients? The market mechanism depends on successful trusts gaining patients while others lose out.
	Some people have asked what will happen to spreading best practice. If one trust is doing particularly well and attracting many patients, there is not much incentive for it to spread the secret of its success. The hospital losers will face bigger deficits; they will have to make more cuts as a consequence and the downward spiral will increase. The real losers will be the patients, although that might not be the case if local accountability was improved.
	At present, the accountability of senior officers in primary care trusts or acute hospital trusts is to politicians at Whitehall. The focus is very much on delivering the targets that the Government want. That may be fine but sometimes it does not take into account local needs and local decision making. Perhaps we should move towards a system with more accountability to local people.
	It seems slightly ironic that the Government are engaging in a large-scale listening-to-Britain exercise and are making knee-jerk announcement after knee-jerk announcement, yet the public feel increasingly that consultations at local level are tokenistic, decisions have already been made and local health managers are not listening.

Mark Hoban: I am grateful to the hon. Lady for raising the issue of public consultation. Does she share my disappointment that mothers in my constituency were told only 14 days before it took place of the closure of the Blackbrook birthing centre? That closure took place as a result of financial and staffing problems in Hampshire PCTs and hospital trusts.

Sandra Gidley: I do not know the details, but it is clearly disappointing that blocks are put in the way when someone has come up with a creative solution to a problem. I have been working with the hon. Members for New Forest, West (Mr. Swayne) and for New Forest, East (Dr. Lewis) on a similar problem, and the hon. Member for New Forest, East came up with a similar idea. It has not been developed, although not for the same reasons. I hate to think that we could have developed our project to an advanced stage only for it to be scuppered at the last moment.
	In many communities, there is a growing sense of anger that health organisations are trying to take away something that belongs to, and is very much part of, the community. In south-west Hampshire, some of us have been working together against the proposed closure of community beds in hospitals in the New Forest and Romsey. We work across the political divide, which has gone down well with the public who regard it as unusual for politicians of different parties to work together. We tried to present a united front to the local PCT alliance to persuade it to rethink the ill-thought through proposals to close hospital beds.
	One option—described by someone as the nuclear option—was to close all community hospital beds in the area. That proposal completely ignored a bed survey that showed a great need for patients to move out of the acute hospital trust and into the cheaper, and some would say friendlier and more homely, community hospital beds. So huge amounts of money are being wasted in the local health economy by keeping people in acute hospitals inappropriately. The scandal is that the managers have not got their heads around moving people more effectively through the system and that the knee-jerk reaction has been to cut the number of beds at one end of the scale.

Sandra Gidley: Ambulance services have frequently been a target for underfunding by other trusts. Again, a lot of this boils down to having good overall strategic management that can ensure that ambulance trusts are funded. As I mentioned earlier, the BMA survey showed that the possible reductions in patient transport can cause great problems for many patients.
	As well as the problems posed to patients by closing community hospitals, what has not been pointed out is the effect on social care budgets. If patients are treated at home, instead of in community hospitals, they become liable for all their personal care needs. That involves means-testing and patients paying money that they probably can ill-afford to pay, but they are often unable to think about that when they are trying to recover from an illness. The burden on social services departments has not been mentioned today. We could have a parallel discussion of the problem of moving patient treatment from health to social services and the impact that that has had on social services budgets, many of which are over-spent.

Kali Mountford: Did the hon. Lady read, as I did, the report by the health service commissioner published earlier this year about the need to make maternity services more locally based? Is she aware that NICE is reviewing midwife-led services to ensure that there are also safe outcomes? Should we not be ensuring that there is a proper balance between locally-based services and ensuring that the outcomes are safe for both mother and child?

Laura Moffatt: No, I will not give way at the moment. We need to put the debate into context, and if we do not do so we shall not have an honest and honourable debate.
	We know how much funding has increased. Indeed, the extra cash that has gone to the NHS is astounding—it is something that we dreamed of. Before 1997, we did not believe that that could become a reality. We therefore have to consider what can go wrong against the background of that extra funding to the NHS, and understand why some trusts get into difficulties.
	I am afraid that for Surrey and Sussex Healthcare NHS trust the pattern of decline was set many years ago when Crawley hospital was not invested in, when its priorities were not foreseen, when it accumulated an enormous amount of necessary repair work and when issues connected with the quality of service were not tackled. I know, because I was a night nurse who more often than not worked alone without the support of senior doctors. So, on the day after the momentous election in 1997, I knew that we would face difficulties, because there was no way that a Labour Government would allow the quality issues in the NHS to be ignored. It would have been easier—

Laura Moffatt: I am very grateful to the hon. Gentleman for raising that issue. I do not know whether he is aware of just what a fantastic contribution he made to ensuring that my constituents knew that I was fighting on their behalf to keep our hospital open. I publicly thank him for his work, because I could not have paid for the publicity that he gave me. I do not think that any Member could be criticised for ensuring that their hospital survives.
	As I said, there was a lack of investment in Crawley hospital. Without doubt, it would be closed by now if the Labour Government had not ensured that money was available to keep it going. The agenda was clear. Without a shadow of a doubt, Crawley was ready for closure, because no investment had been made in it. I am therefore deeply proud of my contribution to efforts to ensure that it remained open.
	The issue of deficits overshadows much good work. My main complaint is that it is difficult to talk about anything other that deficits in any forum, even when £19.2 million of desperately needed capital investment has been made in Crawley hospital. That money has been used to provide a dialysis unit and to upgrade the walk-in centre to an urgent treatment centre that will see people 24 hours a day. Some 85 per cent. of people who came through the door of the walk-in centre will still be entitled to do so to receive emergency care. This debate appears to suggest that everything is wrong, but even in the trust with the biggest deficit in the country significant improvements are under way. Staff are delivering services that I did not even think possible. The trust can offer cardiac catheterisation. People used to go to London to have that done, but they no longer need to do so. A chronic disease management centre is under construction at Crawley so that people can receive walk-in care and will not have to spend weeks in hospital. GPs in my area can now refer dermatology patients for treatment the same week. They used to wait 22 weeks for such treatment.

Nigel Waterson: I am delighted to be able to take part in this timely debate. I called a debate on 6 April about the problems at my hospitals trust. It was the last Westminster Hall debate of the last Parliament. The position then was extremely grave. The trust had issued a press release referring to extreme pressure on the hospital, 97 per cent. bed occupancy over a period of six weeks and 158 operations cancelled, and it was proposing to close accident and emergency for periods because of the severe pressures. The then chief executive said:
	"When levels of bed occupancy reach into the upper 90s risks of clinical errors become unacceptably high."
	I had a meeting at the time with the Minister of State, the hon. Member for Doncaster, Central (Ms Winterton), which she will remember, and she agreed to put a recovery and support unit from the Department into the local NHS. In short, we had some serious problems.
	What has changed since April this year? We had a general election campaign and suddenly, miraculously, some funds were found to ease some of the bed-blocking problems that we had at the time. We already had the highest level of bed blocking in the entire NHS. We have seen nothing of the recovery and support unit. It may have intervened, but as far as I am aware, it has not been to my local hospital. Extra funding has been put in by the county council. East Sussex county council has again had one of the lowest, if not the lowest, settlements of any county across the country, but in the past four years it has managed to increase spending on older people's services by 35 per cent., despite the fact that over that four-year period its central Government grant has increased by only 1 per cent. if one strips out the money passported to education.
	What has the hospital done? It has opened a new, allegedly temporary ward, the Polegate ward, in the car park. It has tried many different ways of reducing the level of bed blocking in Eastbourne and Hastings, yet delayed transfers of care remain at a stubbornly high level. Recently that nearly reached 100 beds—that is, 10 per cent. of all the beds across the whole hospitals trust. That has led to cancelled operations. In a six-month period, 472 operations were cancelled at the last minute. This year the trust is expected to make cuts of £17 million.
	In August the then acting chief executive sent a letter to all consultants in the hospitals dealing with the overspending, making it clear that reducing the deficit and getting back into balance was a priority alongside MRSA reduction, cancer waits, emergency access, waiting times and so on, and pointing out that tough budget decisions were needed, with no issue off limits for debate. The letter mentioned also
	"the burden of decisions which have major safety or 'political' implications."
	One of the problems with the bed blocking has been the difficult budget for social care in the county of East Sussex. We have the highest proportion of over-85-year-olds in the entire country, which has put an immense burden on social and health care. The county council is spending above average per head on the problem, yet contrary to popular belief—it certainly seemed to be the belief of the Minister who answered my debate in April, now the Transport Minister—average earnings in East Sussex are some £5,000 less than the average for England.
	Since April, the problems have got worse, not better. Staff, patients and their families have experienced intense pressure, a high level of operations have been cancelled and the bed blocking is the worst in the entire NHS system.
	In the meantime, we have lost our chief executive, who left in slightly mysterious circumstances, and I have been unable to obtain details of the severance package paid to her. A new chief executive was parachuted into the trust without the post being advertised, without competitive interviews and without any of the other provisions that are normally observed in the public sector. There has been a culture of secrecy at the local trust, although Ministers have stated in written answers that they were not involved. I suspect that the strategic health authority was the real driver behind that culture, but I am yet to accept that there are no ministerial fingerprints. Many of my constituents think that if several hundred thousand pounds—this is a rumour, but rumours can be countered by publishing the details—has been taken out of patient care for a severance package, the matter should be put in the public domain.
	We have a new problem, as well as a new chief executive, whom I wish well given the problems that she faces. Only a few days ago on 9 November, the hospital announced unilaterally that it will turn away patients from out-patients, because it has reached the level agreed in the contract with the local primary care trusts, but the PCTs dispute that point and take the view that it is still under contract. In fairness to the PCTs, they have stepped forward to try to ensure that every patient is seen within the 30-week period, even if patients have to be referred to private providers. I hope that that is what happens, but I do not want to see an additional burden being transferred unilaterally to my local PCTs, not least because they are also in deficit. When I asked the chairman of my local PCT at its annual general meeting in the summer whether the PCT would prioritise patient care or eliminate the deficit, she made it clear that the PCT would put patient care over eliminating the deficit.
	I have tabled an early-day motion asking the Government urgently to review funding in East Sussex for social and health care, particularly having regard to the high proportion of elderly people to which have I already referred. I have not yet received an answer to this vital question: will eliminating financial deficits or the clinical needs of patients take priority under this Government?

Stephen Hesford: The hon. Member for Eastbourne (Mr. Waterson) has said that the debate is timely, and I think that he is right.
	Conservative Members have mentioned the word, "embarrassment", but the two go hand in hand. One of the reasons why the hon. Member for South Cambridgeshire (Mr. Lansley) was unable to answer questions about the patient's passport is that one Conservative party leadership contender likes them, while the other says that they are old hat. Until Conservative Members work out that conundrum, it is embarrassing for them to call a debate such as this. My right hon. Friend the Secretary of State has said that she is proud of what the Government have done for the NHS, and I am proud of how the NHS delivers in my constituency—if I have time, I will raise some relevant examples.
	Conservative Members should also be embarrassed by their motion. I have already questioned the sum of £600 million, which is a gross exaggeration, so I am glad that the hon. Member for South Cambridgeshire is back in his place. When my right hon. Friend the Secretary of State talked about administration costs, the hon. Gentleman tried to focus on management costs. According to the NHS Federation, there are fewer people in management, as a percentage of the work force, than in 1999.
	My hon. Friend the Member for Crawley (Laura Moffatt) indicated how deficits occur. Conservative Members must understand that we inherited an appalling situation. In many cases, any deficits that occur have been rolled over from year to year as a result of inherited deficits from the Conservatives' time in Government. My right hon. Friend the Secretary of State was right to point out that we inherited what Wanless described as a £3 billion cumulative under-resourcing of the NHS. We have been trying to put that right, as well as increasing investment.
	I want to talk about the situation in my constituency. It is often valuable advice for hon. Members to speak about that which they know, and I know the situation in Wirral very well, having for eight years met people from all parts of the NHS every three months in order to understand their story as it has unfolded. It can be painful to shift resources from the acute sector to the community sector to create a primary care-led, patient-led NHS. That can lead to budgetary difficulties. To deal with that, the Government will in due course publish a White Paper on care out of hospital.
	One of the reasons for making primary care trusts focus more on commissioning is to ensure that there is patient choice and direct management control. That means that there is no power struggle between the PCT and the acute trust, as has sometimes happened, and resources can be directed towards an NHS that is properly redesigned for the future. My local acute trust has taken the necessary action to design a service that leads to recurrent savings in resources. As a result, its deficit has disappeared. I commend that approach to Members on both sides of the House and suggest that they should have a conversation along those lines with their own acute trust management.
	When Labour came to power, the budget for my acute hospital was just over £100 million; now, it is nearly £300 million. It is one of the largest non-teaching hospitals in the country. It was an 800-bed hospital; now, it has nearly 1,000 beds. I do not recognise Conservative Members' accusations of bed cutting. Indeed, I had the honour of opening a 12-bed high-dependency unit costing £1.2 million just before the 2001 election.
	If Conservative Members want a serious debate, I thoroughly recommend that they first have a conversation in their own patch to see whether their NHS management is doing all that they could with the money that we have provided, which is more than enough.

Tony Baldry: The House heard an incredibly complacent speech by the Secretary of State. She has fallen into the trap that all Governments fall into in their dying days—that of having her officials only take her to see Government flagship projects. Half her speech was taken up with trumpeting flagship projects, and she did not wish to hear about any of the problems that are being experienced in parts of the country that are suffering from deficits.
	I issue to the Secretary of State the same invitation that I have already issued to her fellow-Ministers—the Minister of State, Department of Health, the hon. Member for Doncaster, Central (Ms Winterton) and the Under-Secretary of State for Health, the hon. Member for Birmingham, Hodge Hill (Mr. Byrne)—in debates in Westminster Hall: please come to Oxfordshire to see the other side of the story. The health economy in Oxfordshire is in freefall. The strategic health authority tells us that in the next six months the Oxfordshire health economy has to save £35 million.
	Those cuts are the responsibility of Ministers. Under the present Government funding system, Oxfordshire receives only 85 per cent. of the national average for NHS funding. Ministers say that that is because Oxfordshire is wealthy compared with other areas, but it is exactly that comparative wealth that presents the NHS in Oxfordshire with some of its most difficult problems. Housing costs are high, as are nursing costs and agency costs.
	What does that mean for our local NHS? The Government's funding plan has already resulted in the proposed closure of the gynaecological ward at Horton hospital in Banbury, and the Oxford Radcliffe Hospitals NHS Trust is considering closing wards at the John Radcliffe hospital and the in-patient pain relief unit at the Churchill hospital. Wards are being closed, beds are being lost, and community hospitals are either not being built or under constant threat of closure.
	The Government's amendment has the audacity to claim that they are investing £100 million in a community hospitals programme. Way back in 1997, the right hon. Member for Darlington (Mr. Milburn) stood at the Dispatch Box and promised the people of Bicester a new and enlarged community hospital. We are still waiting for it. In the other place, Lord Warner cannot even tell us whether community hospitals will have beds. If the Government cannot recognise that a community hospital must have beds, God help us all.
	The Oxfordshire health economy has to try to save £35 million this year, £25 million of which is to come from the Oxford Radcliffe Hospitals NHS Trust. That can happen only under slash-and-burn cuts. Yet when Ministers are asked about that, they do not take responsibility, but pass it on to the strategic health authority.

Tony Baldry: The weak and the vulnerable will suffer as a consequence of the Government's complacency about what is happening in the NHS. More than that, the Government wash their hands and claim that strategic health authorities make the decisions. They say that SHAs can set out recovery plans but I wrote some three weeks ago to the chief executive of the Thames Valley health authority to stress that there was no way in which the Oxford Radcliffe Hospitals NHS trust could save £25 million between now and the end of the financial year. I continue to await a reply. I suspect that the reason is that, yet again, we are undergoing an NHS reorganisation, with all the PCTs in Oxfordshire becoming one.
	There is an added twist in Oxfordshire. Clearly, some wise guy in No. 10 thought that it would be fun to consider putting out the management of the Oxfordshire PCT to the private sector. Ministers cannot even work out whether they want to accept the responsibility for that. The Guardian on Saturday reported that Ministers had given an indication that the PCT in Oxfordshire could not go out to private management. Yet the previous day, the Minister of State, Department of Health, the hon. Member for Doncaster, Central said in a parliamentary answer:
	"No decision has yet been taken on the possibility of any strategic health authority (SHA) tendering for the private sector provision of management services for future primary care trusts (PCTs)."—[Official Report, 11 November 2005; Vol. 439, c. 828W.]
	Why on earth does not the Minister simply say, "PCTs are not going to be allowed to do this"?
	UnitedHealth, whose international director used to be an adviser at No. 10, clearly believed that the trust would be allowed to go out to private management. He wrote to me on 11 November, only last week. The letter stated:
	"The board of the SHA has approved the outsourcing."
	It is interesting that the international director is clearly privy to information that is denied the Royal College of Nursing and Unison. When those organisations had the temerity to ask under the Freedom of Information Act 2000—that is their only hope of discovering anything from the Government—they are effectively told to shut up because any discussions between the SHA, UnitedHealth and other providers are subject to commercial confidentiality. That is what will happen with outsourcing resources from the NHS. We will increasingly be told that we cannot ask questions because events are subject to commercial confidentiality. That is exactly what happened in Oxfordshire. It is a distraction from what should be happening to sort out the deficit and the proposed cuts in the Oxford Radcliffe Hospitals NHS Trust.
	Ministers should do three things. First, they should intervene in Oxfordshire and elsewhere to ensure that SHAs do not impose unrealistic targets for damaging cuts. Otherwise, slash-and-burn reductions will take place not because they make sense but because they are the easiest way in which to save money.
	Secondly, will Ministers please examine the formulae? My hon. Friend the Member for South-West Surrey (Mr. Hunt) and all Conservative Members would say that the Government must consider the formulae and the way in which money is allocated. It cannot be right that Oxfordshire receives only 85 per cent. of the average funding for the rest of the country. If Ministers bothered to come to Oxfordshire, they would realise that areas such as Blackbird Leys in the constituency of the right hon. Member for Oxford, East (Mr. Smith) and wards such as Ruscote and Hardwick are as socially deprived as anywhere in the country. The formula is simply not fair.
	Thirdly, Ministers must ensure that we do not continue to go through the ridiculous organisation and reorganisation of the NHS. How much money has been wasted by initially setting up many PCTs and then reorganising them into single PCTs? Moreover, Sir Nigel Crisp said at the start of the recess that PCTs would be allowed to do one thing but the Secretary of State now claims that they will not be allowed to do it. How does anyone in the NHS have any idea about what is supposed to be happening when Ministers keep chopping and changing their minds about what they expect of NHS organisation?
	I am sorry that the Secretary of State was so complacent this afternoon. Every time an operation or the NHS fails a person in Oxfordshire, I shall ensure that those people have a summary of this afternoon's debate. Labour Members got up and simply told us how wonderful things were in their part of the country. That demonstrates the two nations that the Government have created.

Kali Mountford: I have made it clear that I am not giving way.
	I am glad to say that I believe that the formula as it is now constructed ensures that people in the most deprived areas get the most funding. That is the right way forward. Each person in my constituency gets £7 less than in the neighbouring constituency of Huddersfield. That is hardly surprising since the economic indicators clearly show poverty in Huddersfield and relative wealth in Colne Valley. We make no excuses for that; the formula is perfectly fair.
	We have also ensured locally based provision of health services through the PCTs. All hon. Members should welcome that. Conservative Members often talk about a small state and large people, yet suddenly today, they demand state interference at the most local level. Decisions about the local delivery of services should be made locally. [Interruption.] I am making a case.
	In my PCT, there was huge consultation about the delivery of services. Local people made clear what they wanted from their health service. Thousands of people wrote to me and a case was clearly made to the Government. The Government agreed that the services should cater to local people's needs. People understood that they could join with Huddersfield, which had more money spent on constituents per capita, yet they still preferred locally based services.

Kali Mountford: No, I do not agree because there must be a balance between ensuring that taxpayers' money is spent on the right priorities and local needs. There is no contradiction in stating Government priorities, which, in my experience, usually reflect the concerns of my constituents. For example, let us consider cancer care. It was clear that my constituents wanted the same rate of recovery as the rest of Europe experiences. They were not getting that but we are now well on the way to achieving our targets. I am pleased and proud about that. The hon. Gentleman makes it appear as if my constituents did not want such targets. If they had not wanted them, I would not be here today.
	We are conducting several health reviews in my constituency and I have some concerns about them. Local people should be able to make decisions, not in the interests of doctors or administrators, but in those of patients. That is why I asked the hon. Member for Romsey (Sandra Gidley) about her view of maternity services. She might be interested to learn that her colleagues on Liberal-run Kirklees council agree with me about midwife-led units. We need to learn much more about how they can play an important part in maternity services if they are properly supported. My constituents are concerned about how that service can be delivered to their benefit. Most of them want a choice in their services, and maternity services are as good an example as any of how choice can work.
	A woman who expects to have a perfectly normal birth might want to have her baby at home. That is quite proper, and she is entitled to do that. Should the community decide that it wants a midwife-led unit, it will make that case clearly to the local PCT in the local consultation. People are right to demand from me—as I demand from the health service—that such a unit be run properly and with the right support. We should not therefore set up a maternity service that delivers only 500 babies a year, when there are 3,000 a year being delivered in the Huddersfield royal infirmary. We have to take into consideration not only the number of babies being born in Huddersfield but the fact that we might also have to transfer patients, in the middle of what was expected to be a normal delivery, to the newly built hospital in Halifax, which we are very proud that the Government were able to deliver—no pun intended.
	We have to balance the new ways of delivering health and patient care with value for money and with what the public want. The public have made it very clear to me that, if there is to be a midwife-led unit, they want it to have full hospital support nearby.

Julian Lewis: I hesitate to give advice to the hon. Member for Colne Valley (Kali Mountford). She has many admirers on this side of the Chamber, and I think that I am right in saying that she entered the House at the same time as I did in 1997. I would merely say to her that in the 1997 Parliament it was acceptable for Labour Members to argue that everything was the fault of the previous Conservative Government. In the 2001 Parliament, it was arguably acceptable for that to happen. However, this is the 2005 Parliament and it is incredible to argue that this is all the fault of a Conservative Government who lost power way back in 1997.
	Before I leave the party political part of my speech, I must point out that I would never have imagined that, six months after a general election that the Government won with a majority of 60, the best that the Government could do in a major Opposition day debate would be to get only four Back Benchers—including one whom I believe to be a Parliamentary Private Secretary—to support of their ministerial team. It is a sign that all is not well with this Government.
	My final point about the hon. Member for Colne Valley is that it is precisely because we like and admire her that it is sad to see her having to speak so defensively about a record that she knows in her heart is not satisfactory. I would not discourage her from doing that because, as time goes on, if the Government continue to try to purvey a message of good news to a country that knows that the news is thoroughly bad they will simply lose credibility.
	I come now to the events in the constituencies of New Forest, East, New Forest, West, and Romsey, to which the hon. Member for Romsey (Sandra Gidley) briefly referred. I thank her for the way in which she has co-operated with my hon. Friend the Member for New Forest, West (Mr. Swayne) and me in fighting to save the five community hospitals based in our three constituencies. I was sorry to hear the spat between my hon. Friend the Member for Reigate (Mr. Blunt) and the hon. Member for Crawley (Laura Moffatt) about the fight over which community hospital should be saved in their constituencies. The reality is that if constituencies work together, they maximise their chance of saving all their community hospitals, because this is not a zero-sum game.
	When I asked the Secretary of State whether she valued the role of community hospitals I expected her to say yes. However, I also hoped for an answer to the question whether she thought that their closure was a matter of dogma or of economics. It should not be a matter of economics. During our campaign against the closures—which is not over yet, although things are now looking promising for the five hospitals—we discovered that the running of the community hospitals accounted for between only 1 and 2 per cent. of the total operating costs of the PCTs concerned. Those PCTs admitted, without too much pressure, that the reason they were in gross financial deficit had nothing whatever to do with the cost of running the community hospitals. I am only sorry that the Secretary of State was not prepared to concede that point when I asked her to do so.
	The reality was that five community hospitals were to be closed. There was, however, supposed to be consultation and originally it appeared that the consultation would be on all the possible options. Option one out of five was to keep all the beds, or at least some of the beds, in all the community hospitals. Option five was to close all the beds in all five hospitals. In between, there was a series of cunningly designed options, such as closing one hospital but keeping others open, or closing two hospitals but keeping others open. It was patently obvious what was being planned. The idea was that the consultation would set hospital against hospital, community against community, and then the PCTs would be able to go back and say, "None of the communities can agree on which of their hospitals should survive, so we will just do what we consider best."
	What did the PCTs consider best? Extraordinarily, when the truth was told, they did not like the idea of people being treated in community hospitals. Indeed, one non-executive director of the New Forest PCT, who subsequently became acting chairman for a period, said at an early meeting that treating people in community hospitals rather than in their own homes was archaic. If we wish to develop services to encourage people to be treated in their own homes more than at present, the best way to do that—after all, people do not go into hospital for fun—is to persuade them that if the time comes when their condition deteriorates to the point that they will need in-patient care, those in-patient beds will be available.
	I wanted to finish with a few tips and hints for people campaigning on these issues, but something strange is going on nationwide. It is not clear whether it is a movement among PCT bureaucrats or whether they are being surreptitiously encouraged by the Government. The Government say that they value community hospitals and I would like to believe them. If they do, the movement is among bureaucrats. Whatever, there is an attempt to say that community hospitals are not necessary and that people can be treated at home. That smacks of something that we have seen before—what happened to mental health services when care in the community swung the pendulum too far against professional care in institutions.
	There is a grain of value in what is being recommended, but the reality is that valued, trusted and loved organisations will be thrown away for the sake of dogma. When that dogma is found to have failed, the unelected bureaucrats, whom no one put into power except the Government, and whom no one can remove except the Government, will no longer be there. It is no good the Government saying to us that such decisions must be taken locally—our answer is that such decisions must be taken democratically.

Richard Taylor: While I welcome the extra money going into the health service and some of the improvements that have occurred, I find it incredibly hard to understand why only a quarter of trusts are in deficit, when in my area all three of the primary care trusts and the acute trust are desperately in deficit. I want to try to persuade the Government to admit that at least some of the deficits are their fault.
	At the Health Committee last week, I asked a chair of a strategic health authority:
	"is it not also part of your job to tell the Government that with Agenda for Change, GP contracts, consultant contracts, out-of-hours care and all these further reconfigurations, that even though they put extra money in, you do not have enough?"
	He replied:
	"you are absolutely right that if you look at those examples you gave, whether it is Agenda for Change, the consultant contracts, the GP contracts, all of those cost more money than we originally identified in the arrangements to do it, and we make that very clear to Sir Nigel Crisp and his team when we meet them."
	The Government must therefore be aware that some of the deficits are due to their plans.
	As an independent Member, I have the immense privilege of being able to attack both the previous Government and this Government. I refer the House to an article in the Journal of the Royal Society of Medicine in 2003, which reviewed all the changes imposed on the NHS up to that date, which it called, "organisational upheaval". I am glad to tell the House that the score is 13 to 12 in the Government's favour, or rather disfavour. From 1982 to 1996, there were 12 reorganisations. From 1997 to 2003, there were a further six. By my counting, since 2003, seven or eight more have taken place. The author of that article concluded:
	"perpetual reform is very costly, both in terms of the time and effort invested by managers and other NHS staff, and in terms of the financial costs of establishing the physical fabric of new organisations and of meeting the redundancy or retirement costs of displaced staff."
	The NHS staff who speak to me, locally and more widely, make a sincere plea, "Leave us alone. Let us just do our job of caring for patients. And please slow the reforms."
	As I said in a debate in Westminster Hall this morning, one of the consequences of deficits in my area is that the acute trust is £20 million to £30 million short. Some of that is because of inefficiency, and I welcome the drive for efficiency-increased productivity. I am saddened, however, that there are threats, yet again, to hospital services in my county.
	Apart from threatened reconfigurations, the PCTs have deficits, which affect me and, I suspect, other hon. Members in the form of battles with NICE guidelines. I have had a tremendous battle to get funding for the anti-TNF drugs for rheumatoid arthritis, which are approved by NICE. I am having a battle over biventricular pacemakers, which every cardiologist reckons are far better than the old-fashioned pacemakers, and yet a patient of mine must go before a special complex case panel to be approved to have what is well known to be the most effective form of pacing. There is, of course, a battle over Herceptin, and in my area each case is being examined specifically. There is NICE blight, whereby things that are about to be tested are not even considered by PCTs. Then there are things that are not even on the NICE list, such as the treatment for sleep apnoea. Any Members who are overweight and whose wives tell them that they snore loudly might need that treatment at some point.
	My plea is that we should recognise the causes of the deficits, slow down some of the reforms and give the staff time to care for their patients. It is all very well to rule that GPs must do Saturday morning clinics. But who stopped the Saturday morning clinics? The Government accepted the new GP contract, which did just that.

Mark Simmonds: I agree with my hon. Friend the Member for Banbury (Tony Baldry) about the deplorable complacency of the Secretary of State's speech. She wanted to talk about anything other than the motion, and her responses to the serious points made by my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) were unacceptable. I can be more positive about the hon. Member for Colne Valley (Kali Mountford), who made a typically articulate speech. She made a good case for the abolition of central Government targets. Along with the Government's manipulation of the funding formula, mentioned by my hon. Friend the Member for South-West Surrey (Mr. Hunt), those targets are the main reason for the terrible deficits that most PCTs are now experiencing.
	I warned the Government that they would find themselves in this position as long ago as November 2001, when I initiated an Adjournment debate in Westminster Hall on the future of Skegness and District hospital. I asked the Minister to reassure my constituents and me that when the PCT ran short of money, it would not close wards. What safeguards would the Government introduce to ensure that wards would not be closed and beds would not be lost? The then Minister of State, Department of Health, the right hon. Member for Redditch (Jacqui Smith)—who, rather worryingly, is now Minister for Schools—replied
	"I reassure them and him that they need not fear for the future of what is an excellent community hospital: there are no plans to close or to downgrade it."——[Official Report, Westminster Hall, 13 November 2001; Vol. 374, c. 237WH.]
	On 1 November this year, one ward—50 per cent. of that hospital's wards—closed.
	In January 2003, I initiated an Adjournment debate about the future of Pilgrim hospital, the main hospital in my constituency. I asked the then Minister, the hon. Member for Tottenham (David Lammy) to reassure me that there would be no downgrading of facilities at that important hospital in my constituency. He said
	"I want to assure them from the outset"
	—"them" being my constituents—
	"that they need not fear for the future of their hospital or the future of the NHS under this Labour Government."—[Official Report, 16 January 2003; Vol. 397, c. 919.]
	This summer, two wards in Pilgrim hospital, Boston closed, losing 59 beds—another disgrace.
	I held a debate in July this year, to which the Under-Secretary of State for Health, the hon. Member for Birmingham, Hodge Hill (Mr. Byrne) replied—I see him in his place. I have to say that his response that day was at least more articulate and sensible than either of the two responses that I had received in the previous debates—[Interruption.] Not only did he go to Harvard, he also had an interest in Lincolnshire church architecture, which means that he cannot be all bad. I pointed out that the Government had failed to act in time to stop the ward closures and asked him to put on record his assurance that there would be no further diminution of health care provision in my constituency or elsewhere in Lincolnshire. Even that Minister, however, failed to do so.
	My hon. Friend the Member for South-West Surrey may not have known it, but he hit the nail right on the head. In my view, there has been a deliberate policy by the Government to manipulate public sector funding formula not just in the health service, but across the public sector, to move resources—particularly out of rural areas that have Conservative and sometimes Liberal Democrat MPs—in order to benefit their own MPs, especially in marginal seats. The hon. Member for Wirral, West (Stephen Hesford) has effectively confirmed that today.

Mark Simmonds: I congratulate my hon. Friend on all the work that he has put into getting the CHANT group off the ground. He deserves significant recognition across and outside the House. I am sure that he will be rewarded in his own constituency for the efforts that he has made. I am delighted to see the Conservative Benches so full today: many more Conservative Members will be engaged in improving the provision of health care, not just in our respective constituencies but across the country. The representation on the Government Benches this afternoon provides a marked contrast.
	I want to provide some brief statistics to show the consistent underfunding of the East Lincolnshire primary care trust, which serves my constituency and that of my hon. Friend the Member for Louth and Horncastle (Sir Peter Tapsell), who I am delighted to see in his place. The PCT began on 1 April 2002 with a £2.8 million debt inherited from the former Lincolnshire health authority. In the year 2005–06, it was 8 per cent. off its target share of funding. As much as 36 per cent. of the total underfunding in the Trent strategic health authority area is applicable to the East Lincolnshire PCT, which is one of the 10 worst funded PCTs of the 303 in England. This year, it is £30.3 million below its target level funding.
	It is not only the East Lincolnshire PCT that is underfunded; they all are in Lincolnshire. The United Lincolnshire Hospital NHS Trust is £8.1 million in deficit with a £20 million predicted shortfall this year. That has meant two ward closures and 59 beds lost at the Pilgrim hospital and 15 beds, including three palliative care beds, in the Scarborough ward closed on 1 November. As you can imagine, Mr. Deputy Speaker, there was absolute uproar in Skegness, resulting in very well attended public meetings—[Interruption.] Government Members are laughing, but this is a very serious issue. The meetings culminated in setting up a delegation that is coming to Parliament on 30 November. I ask one of the relevant Ministers to meet that delegation—it will include Labour councillors who attended the Secretary of State's surgery but, needless to say, received no response from her—and hear what it has to say. The losers are people living on the east Lincolnshire coast who need that facility. Pilgrim hospital is 42 minutes away along the A52.
	Due to pressure from myself and others, future funding was supposed to increase from April 2006—by 13.6 per cent. that year and 12.4 per cent. the following year. It has now become clear, however, why the Government were prepared to acquiesce in that increase in funding level. It is because there is going to be a reorganisation, so the PCT may never see the additional money, which may even be transferred away from where it was originally going to be spent. In winding up today's debate, will the Minister give an assurance that the money promised will remain in the original area of the East Lincolnshire PCT and that the SHA will permit it to be committed prior to the reorganisation in April 2006?
	The two specific problems that I have mentioned are the culture of targets and the manipulation of the funding formula. If only it were as simple as that, but unfortunately, the ambulance trust is now under pressure and it has been proposed that 28 ambulances in Lincolnshire and 42 front-line staff should go. It is ironic that I received a letter from Unison, pleading for my support to fight Government cuts in Lincolnshire. What an irony.
	In conclusion, councillors in my constituency have informed me that the Government blocked the acceptance of the local authority's offer to fund the reopening of the ward—they did so for political reasons, as they do not want to alert the electorate to the fact that NHS in Lincolnshire is underfunded—and thereby ensured the closure of the Scarborough ward in Skegness. I am also told that the Government are politically interfering and manipulating the strategic health authority and the primary care trusts right from the heart—pressurising staff, demanding clearance for all information flows, including for MPs, and blocking spending plans. If true, that is totally unacceptable in what is supposed to be a devolved, patient-receptive NHS.
	I want to see health care provision improved in Lincolnshire and elsewhere—not just in areas represented by my right hon. and hon. Friends, but across the United Kingdom. We must all ensure that that happens. Unfortunately, because of the way in which the Government are managing the NHS, it is not.

Mark Hoban: I welcome the opportunity to debate the financial deficit in Hampshire, which particularly affects my constituents. My hon. Friend the Member for New Forest, East (Dr. Lewis) referred earlier to the problems of community hospitals in that part of the county. In a way, Mr. Deputy Speaker, I wish I had a community hospital. The problem in Fareham is that, despite recognition for some years that local people need a community hospital and despite the record investment in the NHS to which the Government refer in the amendment, no community hospital will be forthcoming for the next two or three years at least.
	What we have seen in Fareham is a much-loved popular local facility—the Blackbrook birthing centre—closed at short notice. I referred to it in an earlier intervention on the hon. Member for Romsey (Sandra Gidley). The Blackbrook birthing centre in my constituency has provided care to mothers—many of whom were born there—for many years. It provides mothers who have given birth elsewhere in other units run by the Portsmouth Hospitals NHS Trust the opportunity to go back for some post-natal care for two or three days to help them to bond with their children. Mothers have also used the centre to receive the hands-on practical advice and care that midwives can give in that unit, which they cannot get elsewhere.
	In July this year, the centre was closed with only two weeks' notice. Mothers who had booked to give birth there were told at short notice that they were no longer able to do so because of the combination of staff shortages through sickness and midwives going on maternity leave. Naturally, it was disappointing for mothers to be told that they could not have their children there, but it was also disappointing that the trust did not recognise the problems that the pregnancy of midwives themselves could cause, and that it had to close the unit at such short notice.
	I am afraid that this is not the first time that the birthing centre has been closed for those reasons. Having been closed since August 2000 because of staff shortages and sickness, it reopened in June 2001, only to close again in January 2002, until May of that year, again because of staff shortages. Mothers in my constituency are an easy target. They are the first to feel the pinch when there is a shortage of midwives in the local PCT.
	Recognising the great outcry across the community at the closure of Blackbrook, the trust committed itself to reviewing the question of its reopening in December, and it pressed ahead with recruiting midwives, despite staffing pressures elsewhere in the system. It agreed to recruit 12 whole-time equivalent students and five other midwifery posts, so that Blackbrook—and the Grange maternity centre, which is in the constituency of my right hon. Friend the Member for East Hampshire (Mr. Mates)—could reopen by the turn of this year.
	Local parents have campaigned vigorously to keep both centres in the public eye. I congratulate the "Friends of Blackbrook" and Mel Watson on their excellent work in keeping Blackbrook in the public eye and that of the people of Fareham. But they were stunned, as was I, to discover in September that the trust had postponed the reopening of Blackbrook and the Grange, because it recognised that the financial constraints that have affected all Hampshire's trusts have to be applied to maternity services as well.
	In a letter to me, the director of clinical services, nursing and midwifery said:
	"You will also be aware of the difficult financial situation affecting both the Trust and all of Hampshire and the Isle of Wight . . . The Board agreed that Maternity Services must now be subject to the same financial controls as all other Trust services, even though this may mean the reopening of Blackbrook and the Grange might be delayed as a result."

Maria Miller: I draw to my hon. Friend's attention the fact that the financial crisis in maternity care stretches as far north in Hampshire as Basingstoke, where we have no 12-week scans for pregnant women. The financial crisis has hit us hard, as well, and it is interesting to hear how it is stretching further south.

Stewart Jackson: I am grateful for the opportunity to share with the House the impact of this Government's incompetence and mismanagement on my constituents. In so doing, I pay tribute to the staff and management of my local NHS trusts—the Peterborough and Stamford Hospitals NHS Foundation Trust, and the Greater Peterborough Primary Care Partnership—whose professionalism is enabling them to continue to put patients first, notwithstanding the Department of Health's strategy of buck-passing and neglect. That said, people in Peterborough are fighting back to defend their local NHS facilities. Mary Cook, a former nurse from Orton Goldhay, which is in the constituency of my hon. Friend the Member for North-West Cambridgeshire (Mr. Vara), has collected thousands of signatures in protest at ward closures, cuts in bed spaces and the amalgamation of our local PCTs.
	Mary Cook is not a Conservative, but she is a special lady. In 1996, she won a national newspaper competition, which enabled her to meet the then Leader of the Opposition, the right hon. Member for Sedgefield (Mr. Blair), and to quiz him on the NHS and how his policies would help Peterborough. At the time, she said that she was satisfied with his response. What is her view today? Last month, she told Peterborough's The Evening Telegraph,
	"Looking at his answer now just makes my blood boil. He has more or less gone against everything he told me."
	In April 2000, the right hon. Member for Sedgefield, upon the occasion of the opening of a new NHS walk-in centre in my constituency, told the very same newspaper—in breathless, messianic prose that was doubtless written for him:
	"Not for the first time, the city is blazing a trail for others to follow. You can't rebuild the NHS overnight . . . what you can do is put in the investment and the reforms to get it right."
	So what is the Prime Minister's legacy to my constituents? The Peterborough and Stamford hospitals trust is predicted to be £7.7 million in deficit at the end of this financial year. It has already axed 70 jobs and closed no fewer than three wards and 106 beds. A further 200 jobs are under threat, and cuts of £6.5 million are in the pipeline. Just yesterday, following the local PCT's decision to withdraw £2.5 million-worth of funding, the trust has been ordered to "slow down" elective surgery cases, thus increasing waiting lists and making further cuts inevitable. The Department of Health is happy to preside over the disintegration of local NHS services. It is pressing the trust to meet its statutory obligations under legislation dating from 1990, but it is happy to carry over accumulated structural debt. This dichotomy is unsustainable in its present form.
	What is the trust to do? It is faced with external demands—such as consultants' contracts, agency staff, the European working time directive, initiatives such as "Agenda for Change", and a hugely increased drugs bill—but it has not been provided with adequate funds to meet them. Ministers have not addressed this issue.
	Even when the Government try to involve the private sector, they are noteworthy for their incompetence. Part of the reason for the structural deficit in Peterborough is the mismanagement of the private finance initiative scheme for the building of a new super-hospital in Bretton Gate, on the site of the Edith Cavell hospital. Initially, the cost to the trust of the project's consultants—more than £5 million—was to be underwritten by the Department of Health. Then, it was not. Then, just £1.9 million was to be underwritten. Then, the whole amount was again to be underwritten. Last week, the hospital trust's chief executive warned:
	"We cannot keep running at a loss. We want to give advance warning that jobs are at risk."
	The PCT will fair little better, with a forecast deficit of £4.2 million this year. Its chief executive said that the trust was in a "fragile financial state", with a vacancy freeze and staff morale at rock bottom.
	Meanwhile, patients face longer waiting lists and further cuts in service provision. My constituent in Walton was forced to wait 88 weeks to have a new digital hearing aid fitted at the audiology department—so much for the public-private partnership, and the for the Prime Ministers' honeyed words.
	The problems that I have described are the results of centralised planning and 300 targets. The Secretary of State's approach is similar to that of Stalin's approach to tractor quotas in the Ukraine, although she does not have his sense of humour, flexibility and sureness of touch.
	When will the Government concede that their star rating system is flawed and inaccurate? When will they learn that targets distort clinical priorities and disadvantage patients who need non-targeted, elective surgery but who get pushed to the back of the queue?
	The drive to a monolithic culture, disdainful of the views of local people, continues with the Orwellian behemoth that is known as "Commissioning a Patient-Led NHS". That is newspeak, or doublethink. The plans mean that my constituency has taken on a contingent deficit of £23 million from South Cambridgeshire, and they take no account of patients or professionals.
	Does the Department of Health care that there are major health inequalities in my constituency? Adult life expectancy is four years lower there than in neighbouring Cambridge, and the local PCT has unique health needs and specialties. It is rare for me to make common cause with Unison, but I applaud the union's efforts to defend local health care in my constituency.
	It is time for the Government to acknowledge the crisis, and the fact that they do not have any moral superiority or a monopoly on care about the NHS. Until they do that, we will see more wards closing and more bed spaces lost, rock bottom staff morale and further suffering for my constituents and for people across the country.

Mr. Deputy Speaker: Order. I do not expect such comments from Back-Bench Members, and especially not from a Parliamentary Private Secretary.

Nick Herbert: The Secretary of State gave the clear impression that the deficits described by other Opposition Members do not matter. She said that they affected only a small minority of trusts, but all four acute trusts serving my constituents in Arundel and South Downs are in deficit. The Brighton and Sussex University Hospitals Trust has a deficit of £7.5 million, and that will double by April. The St. Richard's hospital in the south-west of my constituency serves my constituents in the Royal West Sussex Trust and has a cumulative deficit of £20 million, and rising. The Surrey and Sussex Healthcare Trust has been referred to already and has a deficit of £29 million, while the Worthing and Southlands Hospitals Trust has a deficit of £5 million, which is forecast to rise to £13 million by March. That represents a total deficit of more than £60 million, and rising, in the acute trusts in West Sussex alone—hardly a chimera.
	That deficit affects the trusts' creditors; it is not merely a paper deficit. Ministers will know that many of the trusts are unable to meet their bills, and that means that creditors, including those in the private sector, are being made to wait for payment.
	The Secretary of State said that a recovery plan was in place. What does that plan entail in West Sussex? In Worthing and Southlands, it means that two wards will be shut. In the Royal West Sussex Trust, one rehabilitation ward is to be shut, with the consequence that patients are being transferred to Arundel community hospital. That hospital is being told that it can treat fewer local patients than would otherwise be the case.
	In 1932, people in Arundel supported the building of the hospital by public subscription. The bricks were paid for by everyone contributing sixpence each to the building fund. Local people have contributed every year to ensure their community hospital's preservation, and they feel very aggrieved that, in effect, it will be taken away from them.
	In the Brighton and Sussex University Hospitals Trust, accident and emergency services and major trauma services are being transferred from the Princess Royal hospital in Haywards Heath to the Royal Sussex hospital in Brighton. Again, that is strongly against the wishes of people in the local community.
	The Secretary of State gave the game away when she said, on the "Today" programme in June, that some parts of the NHS were "not particularly efficient". She said that
	"individual hospital departments, if they are not able to . . . balance their books . . . will find themselves replaced".
	Is it not clear, therefore, that the recovery plan really amounts to a closure plan? However, when the Secretary of State says that trusts are not being efficient enough, that is to ignore that the St. Richard's hospital in my constituency is one of the most efficient in the country. It is among the top 15 per cent. of NHS trusts nationally, and has accumulated two of the three possible stars in the Healthcare Commission ratings, yet the Government say that it is not efficient. The truth is its efficiency is being penalised by the deficit that it should not be running up.
	The Secretary of State said that deficits were rising in spite of higher resources, but the point is that, in effect, those resources are not available. The King's Fund has pointed out that 73 per cent. of spending increases are being absorbed in cost pressures. Professor Nick Bosanquet of Imperial College has said the same—that 70 per cent. of annual spending rises are being absorbed by inflation.
	The Government have fuelled inflationary pressures in the NHS, and made it less possible for trusts to meet their bills. That is not merely due to an increase in existing salary costs as a result of Agenda for Change and the new consultant contract: it is because the future spending commitments taken on by the Government are not properly accounted for. They include the PFI schemes, the new primary care contract that is being introduced, and the fact that more staff will be taken on.
	Professor Bosanquet has estimated that, in five years, the additional costs will amount to £10 billion a year. That will be funded from within the existing NHS budgets, at a time when the increase in spending will be slowing down. By then, our health funding will be nearing French levels. It will account for 10 or 11 per cent. of gross domestic product, but the NHS will face a French-style financial crisis.
	Hospital managers have no control over those costs, which in effect are being imposed on them. In a national system, they have no way to vary the costs, and the possibility that they might be able to has been taken away. The right hon. Member for Darlington (Mr. Milburn) proposed the introduction of foundation hospitals, but that innovation never saw the light of day.
	There will, of course, be less in the way of resources for health care if the money being put in is not matched by output. The Treasury's initial measure of NHS productivity showed that it fell by a staggering 15 to 20 per cent. between 1997 and 2003. The Office for National Statistics was told to recalculate the measure, but even its revised figures show that productivity has been falling by as much as 1 per cent. a year since 1997.
	Falling productivity means that the NHS needs more resources just to stand still. One reason for that fall in productivity is that there has been an increase in non-productive activity. For example, the latest ONS figures, published last month, show that the number of managers in the NHS in England is increasing three times as fast as the number of clinical staff—that is, doctors and nurses.
	The problem is not that more money has not been put in, but that the money has been put in ahead of reform and consequently dissipated. Higher spending has simply fuelled higher costs. The national problems are exacerbated in West Sussex, where our population is rising, and relatively elderly. As Opposition Members have pointed out, the NHS funding formula discriminates against the south-east.
	I hope that the Secretary of State and her fellow Ministers recognise that the hospitals in my area face serious problems that must be answered.

Andrew Murrison: My hon. Friend tempts me. As I was saying, Blackbrook provided excellent care for Henrietta, my wife and me.
	My hon. Friend the Member for New Forest, East (Dr. Lewis) gave us some helpful campaigning tips on how to secure the future of one's community hospital and, having visited his area, I hope that his forceful local campaign will ultimately be successful. I am sure that it will. The hon. Member for Wyre Forest (Dr. Taylor) was as sage as ever and reminded the House that Ministers have recently applied their micro-management of the NHS to reinstate GP Saturday morning surgeries. He also reminded us that it was the Labour party that removed them in the first place.
	The hon. Member for Sutton and Cheam (Mr. Burstow) expressed concern about Sir Nigel Crisp's announcement last week that he will hold back powers from PCTs at strategic health authority level—concerns that we share. My hon. Friend the Member for Boston and Skegness (Mark Simmonds) will lead a delegation from Skegness—I hope that the Minister will meet it—in support of his community hospitals. My hon. Friend the Member for Peterborough (Mr. Jackson) talked powerfully about the effects of PCT deficits in his area and the causes of them. Finally, my hon. Friend the Member for Arundel and South Downs (Nick Herbert) discussed his concerns about service cuts in his constituency and the underlying reasons for them, which are familiar to all of us who face that problem.
	Nobody disputes the Government's good intentions and they certainly put our constituents' money where their mouth is. However, health outcomes have improved only marginally since 1997 and have, in some instances, declined. International comparisons of mortality and morbidity are unflattering to the UK and output, according to the Office for National Statistics, has fallen.
	The Secretary of State wants views on health outside hospital to inform a White Paper, which we understand will be delayed, although we will probably get it at some time in the new year. In the meantime, I wonder what the outcome was of last month's faintly sinister and highly selective deliberative exercise, "Your Health, Your Care, Your Say". The Department must surely by now have some feedback, so perhaps the Minister can share it with us. We understand that the 1,000 or so participants who took part in that jamboree said that they wanted services closer to their communities. Well, there's a surprise. One did not need to spend more than £1 million to discover that. I could have told the Government that for free from what I hear day in and day out in my constituency. Doubtless, we will hear other startlingly obvious revelations with an extraordinary price tag. I resent that spending, because the apparent £1 million cost of the exercise in Birmingham is approximately the sum necessary to keep my community hospitals, which are threatened with closure, open for a year.
	That brings me neatly on to one of the main consequences of PCT deficits that has been raised today. It was the subject of a well attended meeting upstairs this morning and the mission of CHANT or Community Hospitals Acting Nationally Together. I confess that that is a tortured acronym—for which we are indebted to my hon. Friend the Member for Beverley and Holderness (Mr. Stuart), who is heavily bandaged at present—but it grows on one. I hope that it will appeal to the Minister and I am sure that she will hear more of it in coming weeks.
	There are four community hospitals in my own constituency—Bradford on Avon, Trowbridge, Warminster and Westbury. The quality that they and 400 like them provide is undisputed. The cost per case treated is capable of manipulation, but the best evidence that we have suggests that community hospitals are highly competitive. They are characterised by strong local support, local fundraising and of course by leagues of friends that have over the years provided the NHS with substantial subsidies.
	Community hospitals also have a dedicated work force—people who are expert in what they do and are pleased to serve at the less glamorous margin of our health care system, secure in the knowledge that their largely unsung work is contributing massively to the well-being of their community. Any large organisation must base itself around its skilled work force and Ministers must not assume that those wonderful people will relocate to the nearest district general hospital or shiny new independent sector treatment centre if their hospital is closed down. As community hospitals close, it is likely that many will simply be lost to the NHS altogether.
	Despite all the virtues of community hospitals, Ministers do not have a clue how many community hospitals there are, or where they are. I know that because I have asked them. Nor do Ministers know how many are under threat, so we have been forced to conduct our own research. It appears that more than 90 community hospitals are under threat and the figure could be higher. What is more—and this is the crucial point—there appears to be a strong correlation between PCT deficits and community hospital closures.
	Many of the PCTs in trouble serve small towns and villages, and we know from the Government's research that they are relatively underfunded. That puts to bed the notion that shutting community hospitals is all about improving health services. It is not: it is all about dealing with Government-inspired deficits, especially in parts of the country with which Ministers have little sympathy. However, care in community hospitals is as cheap as chips compared with similar treatment in a district general hospital. Closing them would surely cost more, as patients default to other providers.
	The trouble is that the same Secretary of State who is comfortable using her long screwdriver to micro-manage the NHS—as shown by her insistence last week that PCTs reinstate out-of-hours GP cover—told me when we met a few days ago that hospital closures are entirely a matter for local decision making. Other hon. Members tell me that they have had a similar response and that the Secretary of State is adept at interpreting the comments of local overview and scrutiny committees in a way that creates a pretence of local accountability. Faced with deficits that are largely not of their making, trust chief executives scratch around trying to square away their little bit of NHS budget as they are legally obliged to do, and naturally they light upon community hospitals. The cost of closure to the wider health care economy, including social services and acute units, let alone patients and carers, is of secondary importance and the person in overall command—I hope that the Secretary of State is listening—is unwilling to take charge.
	The Secretary of State was pleased to wave a copy of her party's election manifesto at me when we met the other day to discuss community hospitals, especially those in my constituency. The manifesto contains a clear and unambiguous commitment to community hospitals, but PCT deficits are closing them down. We are entitled to ask when the Secretary of State's action will match the rhetoric.

Jane Kennedy: Once again, we have an Opposition day debate that has generated more heat than light from Opposition Members. The Government are taking the NHS forward to a better future, not condemning it to the failures of the past under the previous Government. The NHS is safe with the Government. Access to operations will remain based on need, not on ability to pay.
	The Opposition have form. Their 2005 manifesto was clear about what they really wanted to do with the NHS. They wanted to charge for operations. They wanted to make cuts and to take money from mainstream health services and give it as a subsidy to the rich few so that they could jump the queue. They said a lot about deficits during the debate—

Chris Grayling: I beg to move,
	That this House notes the recommendation made by the Committee on Standards in Public Life that there should be an independent Adviser on Ministerial Interests; and insists that the Government should immediately begin the process of establishing such a position.
	Let me start by saying that it is always a pleasure to debate with the Minister, but I am sure that even he would agree that it is nothing short of astonishing that we still do not have a Chancellor of the Duchy of Lancaster to lead for the Government in tonight's debate three weeks after that vacancy was created. It is no sign of the Prime Minister's confidence in the importance of the Cabinet Office.
	This debate follows a number of recent controversies, including the resignation of the former Secretary of State for Work and Pensions, creating the vacancy to which I referred. However, the purpose of tonight's motion is not to rake over the coals of that resignation—that would be wrong and inappropriate. The events of the past few weeks have raised important issues about the oversight of the ministerial code and, in particular, have reinforced criticisms made by Sir Alistair Graham, who chairs the Committee on Standards in Public Life. The Government have ignored those issues for too long, but in the wake of the resignation of the right hon. Member for Sheffield, Brightside (Mr. Blunkett) they can no longer be allowed to do so.
	My hope is that the Government will not seek to oppose the motion, but that they will instead accept its inevitability. In the Government's amendment, they claim that they will make an announcement on these matters "shortly". We have been waiting for that announcement for the past two years, much to the fury of those involved in putting together the original recommendation by the Committee on Standards in Public Life. Frankly, shortly is not good enough.
	The Government have always made the right noises over standards in public life. They have introduced a stronger ministerial code and made tough noises about keeping to it. In the introduction to the code, the Prime Minister is unequivocal about its importance:
	"In issuing this Code, I should like to confirm my strong personal commitment to the bond of trust between the British people and their Government. We are all here to serve and we must serve honestly and in the interests of those who gave us our positions of trust."
	Those are fine-sounding words, but on many occasions they have proved to be just that—words and not a yardstick by which all ministerial action is judged. Fine words, little action.
	I want to give the House some other wise words that were passed to me by one my constituents on the day after the resignation of the Secretary of State for Work and Pensions. The words come from one of the House's most distinguished and much missed figures. My constituent said:
	"I may have told Chris the story of how I decided to go to the Scott enquiry one day, was told I had to get into the queue by 8 if I wanted to be sure of getting in at 10, and found myself to my surprise next to Robin Cook. At one stage I asked him whether the Matrix Churchill business was just a one-off with particular people being in particular places at the same time or whether it was something endemic in the British system of government. He gave what I thought was an excellent answer—No, it wasn't either of those—it was more that when one party had been in power for a long time Ministers become progressively less able to distinguish between the public interest, their party interest and their private interests."
	Those words were spoken in a very different period of government, but they ring true today. Ministers, from the Prime Minister down, seem to have forgotten the things that they said in opposition and the commitments that they made when they came to power. Either that, or they just do not think that the rules do not apply to them.
	The origins of the motion lie in the work done two years ago by the Committee on Standards in Public Life, now chaired by Sir Alistair Graham, but then chaired by Sir Nigel Wicks. Government Members will remember the establishment of the committee in the mid-1990s, after the last Conservative Government found themselves under pressure about standards from the right hon. Member for Sedgefield (Mr. Blair), who was then Leader of the Opposition. The then Prime Minister described the committee as a welcome response to "public anger" and claimed that
	"the warning signs over these issues have been ignored for much too long."
	Tonight, my charge against the Prime Minister is that he is guilty of the very offence of which he accused his Conservative predecessors. The warning signs have been present for much too long, and he continues to ignore them.
	Not one but two Cabinet Ministers have resigned twice from the Government. One of them, the European Commissioner Peter Mandelson, even appears to have been guilty of a third offence of not declaring a position that he accepted with the Advisory Committee on Ministerial Appointments. If he were still a member of the Government he would now be in danger of an unprecedented hat-trick of resignations. Unbelievably, he said:
	"Why cannot ex-Ministers face the same requirements concerning their business appointments as civil servants?"—[Official Report, 2 November 1995; Vol. 265, c. 479.]
	Mr. Mandelson went on to ignore those very requirements when he left office.
	Other examples have been in circulation in recent weeks. One Cabinet member apparently rushed to lodge a declaration of interests with the permanent secretary under the ministerial code only when a newspaper started to ask difficult questions. I sometimes wonder whether Ministers think that they enjoy some kind of moral superiority and that the rules do not apply to them. In fact they do, and it is time that there was proper independent scrutiny to stop them ignoring their responsibilities in an often cavalier way.
	Two years ago, the Committee on Standards in Public Life completed its ninth report. It is, as always, a comprehensive and detailed work that looks at a wide range of issues that affect the governance of our country. A key part of its work that year was to look at the detailed workings of the ministerial code. In particular, it set out two key recommendations, one of which is central to tonight's motion. I hope that the Government will give the other recommendation due consideration in the light of recent events.
	Let me set out for the House the recommendation that I will ask Members to support at the end of our debate. The committee called for an independent office-holder—called an adviser on ministerial interests, to be established to provide advice to Ministers on compliance with those sections of the ministerial code that cover the avoidance of perceived and actual conflicts between their public duties and private interests, formal or otherwise. The committee went on to say:
	"The Ministerial Code should be amended to require an incoming Minister to provide the Adviser . . . with a full list in writing of all interests which might be thought to give rise to a conflict . . . the Adviser should consult the Minister's Permanent Secretary about departmental business where necessary to enable the Adviser to ascertain whether a conflict of interest may exist . . . The Adviser should be responsible for maintaining a record of ministerial interests and should keep a note of action taken by a Minister on taking up office . . . The Adviser should publish information and guidance on how Ministers should deal with conflicts of interest . . . Where unforeseen conflicts arise subsequently during the course of a department's work, the Minister should consult the Adviser."
	Finally, the Committee said:
	"The Adviser should refer any breach or allegation of a breach to the Prime Minister."
	That seems to be an eminently sensible set of recommendations. At present, the system requires Ministers to refer their interests to their permanent secretaries, and any breaches are a matter for the Prime Minister.
	That system is clearly flawed. Government Ministers, particularly Cabinet Ministers, are required to work on a daily basis with their permanent secretaries, so a close personal working relationship is established. It is entirely wrong to ask permanent secretaries to serve as the referee for the financial and other dealings of Ministers, as that risks compromising that day-to-day working relationship. That was certainly the view of Sir Nigel Wicks and his committee in the report:
	"Permanent Secretaries should have no responsibility for giving advice to Ministers on conflicts of interest arising under the Ministerial Code."
	The role of the Prime Minister as both poacher and gamekeeper is one that should be questioned, and I will return to that in a moment. The system places the Cabinet Secretary in an extremely difficult position. Two weeks ago, both the right hon. Member for Sheffield, Brightside and I wrote to the Cabinet Secretary about his breach of the ministerial code, which he failed to consult before taking appointments outside Government after leaving ministerial office. The Cabinet Secretary replied to both of us. In his reply to the right hon. Gentleman, he said that he believed that there had been a breach of the ministerial code. In his response to me, however, he made it quite clear that that was not a matter for him. I do not blame him for that, but there is a confusing situation, which is not tenable.
	One of the people who contributed to the work of the Committee on Standards in Public Life two years ago was Peter Preston, former editor of The Guardian. His view was typical of many people involved in producing the report:
	"I said to an earlier meeting of this Committee some years ago that I thought it was completely wrong that Cabinet Secretaries should be wheeled on, as sort of ad hoc men of probity, when there was a question under the Ministerial Code . . . If the supreme code, the Ministerial Code, now much embellished under this government, does not have an independent element in investigating and deciding what happens under it, everything else becomes bendy and much less satisfactory than it should be."
	I hope that our debate tonight will mark the start of a process that will redress that situation. Furthermore, the motion before the House seeks, in substantial measure, to follow a path already accepted by the Government two years ago. That is why I dispute the Government amendment. Two years ago, the Government accepted many of the principles behind our motion, but they have done nothing since. That is why we do not accept the platitudes in the Government amendment. Why cannot the Minister accept the Opposition motion or at least give the House a straightforward timetable for their plans? The word "shortly" is simply too vague for us to accept.

Chris Grayling: The hon. Gentleman is right that there are two recommendations and I intend to deal with both of them. Our motion is designed to put in place an independent adviser on ministerial interests, and I hope that he will accept my explanation of why that is the first step. I believe that both recommendations are desirable, but in tabling the motion I hoped that the Government would accept the first one, although I fear that I will be disappointed.
	The Government did not agree with all the committee's recommendations on the ministerial code. They did not like all the proposals for an independent adviser and they wanted to leave permanent secretaries as the focal point for discussions about the code. However, as the Minister will know, they accepted that it would be sensible to have an independent adviser from whom additional advice could be sought by both Ministers and permanent secretaries. At the very least, that would provide a second opinion for Ministers in difficult situations. Nothing, however, has happened. The chairman of the Committee, Sir Alistair Graham, has expressed anger about that and went public with criticisms of the Government this summer. I asked him if his Committee would make recommendations about the role of prime ministerial spouses, the rules that apply to them and the support provided for them after public concerns were expressed about the commercial activities of the Prime Minister's wife. Sir Alistair gave me a direct response. He stated:
	"The Ministerial Code, as revised and published on the day before the Recess, makes it clear that proper consideration of Ministers' private interests include the private interests of a spouse or partner (paras 5.1–5.3]. In its Ninth Report . . .the Committee made a detailed proposal . . . for the creation of an Adviser on Ministerial Interests whose advice and guidance might have been useful in the circumstances you drew our attention to. Unfortunately, while the Government in its Response (Cm 5964, September 2003) accepted the case for appointing an independent adviser (Ibid, pp. 2–3) no action has been taken."
	That is not from me or from a member of the Conservative party, but from the independent chairman of the Committee on Standards in Public Life.
	That was not the only time during the summer that Sir Alistair had cause to criticise the Government. In July, he expressed great unhappiness at the way in which the Government had dealt with the issue of the code of conduct for special advisers. He expressed
	"dismay at the way the Government had changed the legislation governing the role of Special Advisers without proper parliamentary or public debate"
	and stated:
	"I am naturally disappointed that the concerns my Committee raised about the revisions to the Code of Conduct have not been taken into account."
	What is the point of an independent committee to monitor standards in public life if the Government of the day do not listen to what it says? Is it not the height of arrogance for Ministers who railed about public standards when they were in opposition to turn round and act as if the independent mechanisms that they demanded then do not have to be listened to now that they are in office themselves?
	The other central issue in the debate tonight is the role of the Prime Minister as ultimate arbiter of the ministerial code. That surely cannot satisfactorily remain in place in the future. We have seen in the past few weeks issues about the ministerial code raised over the activities of one of his closest friends and allies in the Cabinet. There is no doubt that the loss of the right hon. Member for Sheffield, Brightside was a major blow to the Prime Minister at a time when things are just a little heated within his party, yet it fell to the Prime Minister to be the judge of the rights and wrongs of the situation.
	In the past few months legitimate questions have also been raised about the commercial activities of the Prime Minister's wife and how they relate to the ministerial code. In these two cases, involving a close colleague of the Prime Minister who can provide advice to him, and the Prime Minister's wife, which raises questions about who she turns to for advice, how can the Prime Minister possibly fulfil the role of ultimate arbiter of the ministerial code?
	When the issue of the Government's support for the businessman Lakshmi Mittal arose, criticisms were directed at the Prime Minister and questions were asked about his conduct. Yet on questions about the Prime Minister's action and guidance to the Prime Minister, the ultimate referee was the Prime Minister himself. That cannot be the proper way of handling standards issues in a modern democracy.
	The question has also been raised about the ability of any Prime Minister to serve as overseer or arbiter of the code, given all the other pressures on him or her. During the last few hours in office of the right hon. Member for Sheffield, Brightside, the Prime Minister at one point openly admitted that, owing to pressure of work, he was not fully up to date with what was going on. Of course he cannot be. The Prime Minister of the day cannot be expected to fulfil that role and to have the time to study everything that is going on.
	That is why I hope the Minister will give an indication tonight that the Government will consider the creation of the other element of the recommendations to which the hon. Member for Cannock Chase (Dr. Wright) referred a moment ago—not simply an independent adviser, but an independent investigatory process for people who are alleged to have transgressed in relation to the ministerial code, and where there are doubts whether the ministerial code has been fulfilled.
	The Committee recommended that
	"At the beginning of each Parliament, the Prime Minister should nominate two or three individuals of senior standing after consultation with leaders of the major opposition parties.
	(b) The names of these individuals should be made public.
	(c) Should the Prime Minister consider an investigation into an allegation of a breach of the Ministerial Code appropriate, the Prime Minister would invite one of these individuals to conduct that investigation.
	(d) The individual selected to carry out an investigation should investigate the facts and report his or her findings to the Prime Minister, who would decide on the consequences for a Minister. The report should be published."

Jim Murphy: I beg to move, To leave out from 'House' to end and add:
	"acknowledges that, amongst other measures, this Government introduced a requirement for individual Ministers, on appointment to each new office, to provide their Permanent Secretary with a full list in writing of all interests which might be thought to give rise to a conflict; welcomes the section of the Ministerial Code on handling Ministers' private interests which is more comprehensive than Questions of Procedure for Ministers; and recognises that this Government has agreed to appoint an independent adviser to provide Permanent Secretaries and Ministers with an additional source of professional advice as required and will make an announcement on this shortly.".
	The hon. Member for Epsom and Ewell (Chris Grayling) began by saying that he would not rake over recent events, before he raked over every recent insinuation. The good thing about debating with him is that he always gives advance notice in a rather polite way of the points that he is about to make through the pages of the Daily Mail. He is often tempted to behave like a Daily Mail copywriter, and he always succumbs to that temptation.
	It is important to put the debate about standards, openness and the ministerial code in context. We have always made it clear that the public should expect the highest standards of propriety in public life, and this Government have introduced transparency, which did not exist under previous Conservative Administrations. That transparency relates to Ministers, special advisers, Parliament and the public.
	We were the first to publish a ministerial code and the annual list of gifts to Ministers, which was strongly opposed by the previous Government for whatever reason.

Jim Murphy: No, it has not. The ministerial code was first published in 1997, and the hon. Gentleman will have an opportunity to discuss that matter. [Interruption.] He is contradicting his own intervention from a sedentary position. What was published in 1992 was not a ministerial code—it was called something entirely different—and it was reformed, reviewed and extended to make it much more powerful. He is making the winding-up speech for the Opposition, so he should not contradict his own intervention.
	We were the first to publish a ministerial code and a list of gifts worth more than £140 that are given to Ministers, and we were also the first to publish a code of conduct for special advisers, the number of special advisers, the cost of special advisers and the names of special advisers, none of which happened before. On openness in Parliament, the Prime Minister was the first to appear before the all-party Liaison Committee, which was previously unheard of, and opportunities for pre-legislative scrutiny have also increased.
	On public openness, we have the long-campaigned-for Freedom of Information Act 2000, which was long opposed by other parties.

Jim Murphy: The hon. Gentleman spoke for a substantial period of time, and I want to make some progress before I give way.
	In contrast to what went before, the ministerial code is updated and published after each general election, so the most recent version was published in July 2005. The ministerial code provides guidance to Ministers on how they should act and arrange their affairs in order to uphold the highest standards of constitutional and personal conduct in the performance of their duties.
	The new ministerial code takes into account a recommendation from the Committee on Standards in Public Life and is split into two parts—a ministerial code of ethics and procedural guidance for Ministers. Ministers are personally responsible for deciding how to act and conduct themselves in the light of the code and for justifying their actions and conduct in Parliament. The Prime Minister is the ultimate judge of the standards of behaviour expected of a Minister and of the appropriate consequences of a breach of standards. Given the wide range of topics covered by the ministerial code—they range from appointments made by Ministers to arrangements for contacting diplomatic posts overseas in relation to ministerial travel plans—the Prime Minister should not be expected to comment on every allegation, although Conservative Members expect him to. As the Public Administration Committee said in its report, "The Ministerial Code: Improving the Rulebook":
	"It is not possible for a Ministerial Code to cover all possible cases and circumstances. Nor should that be its purpose. It should identify the basic ethical principles of Ministerial conduct".
	Turning to the specific point raised by the hon. Member for Epsom and Ewell about the independent investigation of alleged breaches, as my hon. Friend the Member for Cannock Chase (Dr. Wright), who chairs the Public Administration Committee, has said, the Committee on Standards in Public Life considered the merits of the appointment of an independent investigator in its sixth report in 2000. The Committee concluded that it would be
	"undesirable to make a recommendation that would fetter the Prime Minister's freedom",
	and it went on to recommend that
	"No new office for the investigation of allegations of ministerial misconduct should be established."
	The Committee reversed its position in its ninth report, but the arguments that it advanced in its earlier report are still valid. We have not changed our minds on that.
	This proposal involves a point of principle and a point of practicality. It strikes at the principle of democratic accountability and the way in which the Government are run. The electorate decide who is in power and the Prime Minister decides who serves in his or her Government. My right hon. Friend the Prime Minister made the position clear in his press conference on 7 November when he said:
	"The only person who decides who is in the Government or not in the end is the Prime Minister. You can't subcontract that decision. That is why I didn't agree with the recommendation and still don't."

Jim Murphy: The debate on standards in public life is very wide-ranging. There have been written questions about the matter that my hon. Friend raises, so I have of course been briefed about it. The fact is that the Cabinet Office did not clear such a book—

Jim Murphy: Thank you, Mr. Deputy Speaker. In light of your strictures, I undertake to place a record of what the Government and the Cabinet Office did in that respect in the Library so that everyone—Members of both Houses of Parliament and the media—can have access to it.

Jim Murphy: I thank the hon. Gentleman for his compliment and take it in the spirit that it was offered. However, he will single-handedly ensure that the future that he predicted does not happen if he persists with such compliments. I know that he is a good and honourable person and I assure him that there is no complacency. The Government continue to consider ways in which to improve standards in public life. They have done so since 1997 and continue that drive.
	As I said, we were the first Government to introduce a ministerial code, the Freedom of Information Act 2000, cleaning up party political donations, pre-legislative scrutiny, the Prime Minister's attendance at the Liaison Committee and many other things that simply did not happen under the previous Administration, despite the well catalogued failings of standards in public life. Belmarsh almost began its own Conservative Association as increasing numbers of former Conservative Ministers went there.

Fraser Kemp: On that question of Conservative ethics, the hon. Member for Epsom and Ewell (Chris Grayling) was uncharacteristically reticent when I raised the recommendation from the noble Lord Neill that there should be an investigation as to whether the ministerial code should apply to Opposition Members. Will the Minister at least consider those recommendations to avoid impropriety on either side—not to engage in party political point scoring—and to make sure that the probity of the House, Ministers and shadow Ministers is always maintained?

Jim Murphy: Time is running out, and the hon. Gentleman will have time to respond to this point and that about shadow Ministers' accountability when he winds up.
	There is a UK Parliament and a UK general election, and we are elected here by our constituents. I hope that the previous intervention was not some sort of sideways endorsement of the Liberal policy of proportional representation, on which we would disagree strongly. On the question of Short money, some people have started to ask about value for money and the public ethics of it. I will leave that legitimate point there, and the hon. Gentleman might respond to it later.
	I will try your patience, Mr. Deputy Speaker, if I continue for much longer on the question of Opposition accountability in relation to the ministerial code and use of taxpayer's money—£22 million of it since 1997. I want to thank the Conservative party, however, and I look forward to its response as to whether it is willing to adhere to the same standards as Ministers.
	Had it not been for the galling sight of two Ministers committing perjury, and for the fact that a number—not all—of Conservative Members of Parliament were lining their own pockets from asking questions in this Chamber, the momentum for many reforms, in terms of the growth in regulation of our body politic, important decisions about the ministerial code, openness in government, overseas donations and publishing the list of gifts to Ministers, would not have been in place. In that at least, we find common cause. We thank the Conservative party for getting itself into such a mess prior to the 1997 election that we have been forced to clean that up. We do not, however, feel any sense of complacency, and we will continue to find ways of improving our body politic. That is an issue on which the public will judge us each and every day, and come the general election.

David Heath: Yes, and is it not interesting to note that the forerunner of the ministerial code was published in 1917 under the prime ministership of David Lloyd George—a great Prime Minister of this country, but someone who was prepared to sell peerages in return for donations? Well, that could never happen now, could it? At least Lloyd George had the clarity and transparency to provide a clear tariff, so everyone knew what was happening, but the hon. Gentleman is absolutely right to make that point.
	The Minister said earlier that sleaze was endemic in the Major Government. It may have been, but many of us are concerned to prevent that endemic disease from becoming a pandemic, in which all political parties are seen in exactly the same light as that historical position in respect of the Conservative party under Major. Complacency is greatly misplaced on this matter, as it does not take much to cause a generalised infection. I would like to quote a gentleman called Paul Masefield, speaking on Star Sports channel:
	"One bad apple in the dressing room and everything can go pear-shaped."
	Yes, it can, and the Minister should be aware of that.
	Let us examine what the ministerial code says. Much of what it says is good. For example, it states under paragraph 1.5 that Ministers are required
	"to uphold the administration of justice and to protect the integrity of public life."
	Absolutely right. Under paragraph 1.5.f, it states:
	"Ministers must ensure that no conflict arises, or appears to arise, between their public duties and their private interests".
	Again, that is absolutely right. Then there is clear—I think, unambiguous—advice under paragraph 5.29:
	"On leaving office, Ministers should seek advice from the independent Advisory Committee on Business Appointments about any appointments they wish to take up within two years of leaving office."
	I find it very difficult to understand how anyone could misunderstand that particular provision.
	In some aspects, then, the ministerial code is well constructed, but I could also cite paragraph 1.3, which states:
	"The Code is not a rule book, and it is not the role of the Secretary of the Cabinet or other officials to enforce it or to investigate Ministers, although they may provide Ministers with private advice on matters which it covers."
	The question that people outside the House are asking is: what is the point of having rules if no one is enforcing them? The answer from the Government, of course, is that the Prime Minister enforces those rules. Well, the Prime Minister has many qualities—some good, some bad. One of his qualities that many would consider admirable is loyalty to his colleagues, but such loyalty is not a substitute for policing the ministerial code in the manner in which it should be policed. On the basis of the investigations that the Prime Minister has carried out into Cabinet colleagues over recent years, I have to say that the only possible conclusion that one could reach is that the code can be breached with impunity. That should not happen and it reflects badly on the Prime Minister as well other members of his Government.
	The hon. Member for Peterborough (Mr. Jackson), who is no longer in his place, argued earlier that Ministers were more lightly policed in respect of their adherence to standards in public life than the average parish councillor. How can that be right? How can it be that Ministers who wield enormous powers over the budgets that they control and who take such important decisions are more lightly policed in respect of standards of public life than a parish councillor who, with the best will in the world, controls very little beyond some donations to the local village hall or the local recreation field? That is a matter of genuine concern, and I simply do not accept the defence of inadvertence. Explicit advice is given in the ministerial code, and if Cabinet Ministers are inadvertent as to what they should be doing, frankly, they are not fit to be Ministers of Cabinet rank.
	So what can be done? First, we should have a debate along the lines of our perennial Standing Committee debates, in which it is often said of a particular Bill that we should delete "may" and insert "must". The ministerial code should say not that a Minister "should" do something, but that a Minister "must" do something. Secondly, there must be an absolute ban on Ministers taking up paid directorships or employment for two years following their leaving office, unless the advisory committee has said that doing so is acceptable. Such behaviour is incredibly corrosive. If Ministers are seen to be walking away from their Departments and joining companies with interests that are directly relevant to the Departments that they have just left, every civil servant will ask, "Why can't we do the same?" Every member of the armed forces who works in procurement will ask, "Why can't we do the same?" Every time that such things happen, the public's confidence that decisions are being taken with the proper interests of the country in mind is damaged.
	I set aside the question of why it is assumed that a Minister has to have a highly paid job on leaving office. I take the puritanical view that I am a Member of Parliament, and that is my job. I do not see the need to have additional jobs, but I know that other Members take different views on the appropriateness or otherwise of paid employment. What is absolutely clear is that Ministers get generous severance pay on leaving office. Indeed, sometimes they get severance pay several times over, which is another matter that we might consider.

Tony Wright: I am grateful to the hon. Gentleman who raised several points. I shall deal with two of them if I may. First, do I think that standards have gone down? No, I do not; they have gone up quite considerably. The tragedy is that we have given people grounds to think that standards have gone down while in fact they have been rising. Not only have they gone up, but any intelligent historical or comparative tests show that we probably have the least corrupt way of doing politics of almost any political system in the world—across party. Why then do we spend so much effort trying to suggest that our political opponents are corrupt and sleazy? Because we think there may be some temporary political advantage in doing so. That brings me to the hon. Gentleman's second point, which is about resignation.
	The hon. Member for Epsom and Ewell (Chris Grayling) has never knowingly undersold when making allegations against Ministers, usually demanding their resignation. But when someone jumps up every time anything happens, however minor, saying, "This is a scandal. This is outrageous. This is a resigning matter", when they go through the whole hyperbolic routine, the effect is to diminish regard for political life. Indeed, it loses the sense of the moment when that kind of language is required because something serious really has happened. Across the House, we have a responsibility to be far more intelligent and sensible about such matters.

Tony Wright: That is the impression that the hon. Gentleman has given me and many other people. I really am not making a party political point and I am certainly not making a personal point. We would be doing just the same thing. We would have the same knee-jerk reaction: talking up the incident to make it a major constitutional scandal, expressing outrage that standards of conduct in Government had been breached and suggesting that the consequence should be a ministerial head rolling. I merely suggest that that is not an intelligent or sensible way of doing politics—not if we care for the regard in which, on the whole, an uncorrupt political system is held by the people we represent.
	I conclude, therefore, that it is not necessary or desirable to think about inventing yet more ethical regulators, as the motion proposes; it would simply be desirable, in terms of the motion, to correct the wording in the ministerial code. If the motion proposed that the words "are advised" in paragraph 5.3,
	"Ministers are advised to provide their Permanent Secretary with a full list . . . of . . . interests",
	be changed to "should", I would give it my wholehearted support. That is all that is required.
	It would diffuse accountability to the House if the proposition is that we introduce another ethical regulator on to such a crowded field, when it is actually entirely clear—or should be—what Ministers should do and what permanent secretaries should do. Once we begin to cloud the process, and other people are involved, accountability is diminished and diffused rather than enhanced.
	Earlier, I made the case for an independent investigator, a point that was raised by the Public Administration Committee back in 2001, long before the Committee on Standards in Public Life got involved. For all kinds of reasons, I am as attached to that proposition now as I was then. The time has come to take a fresh look at the whole field of ethical regulation—all the bodies that we set up for particular reasons at particular moments—and to try to sort them out. As part of that sorting out, I hope that we shall introduce an independent investigatory element.
	I end by saying that the Prime Minister said that
	"no one will be better governed through fine-tuning the ministerial code."—[Official Report, 13 July 2000; Vol. 353, c. 1098.]
	I have some sympathy with that view, but people will be better governed if they have more confidence than they now do in the system that we have to maintain probity in government. That is a serious matter; it deserves to be taken seriously, but we are not well served if we play party games with it because we will find that we are all brought down by that and the whole of public life will suffer as a consequence.

George Young: It is a pleasure to follow the hon. Member for Cannock Chase (Dr. Wright), who speaks with great authority, conviction and knowledge on the subject. I concur particularly with what he said towards the end, but I wonder whether he asked himself the right rhetorical question halfway through his speech. The question he posed was whether public trust and confidence in us was increased as a result of what he described as the crowded field of ethical regulators. He concluded that, although standards may have risen, public confidence had decreased. The real question is where would public confidence have been if we had not responded to the concerns over the past 20 or 30 years and done nothing—if we had not set up the Register of Members' Interests and the House procedures to deal with MPs' conduct. If we had not responded in the way that we have, public trust in us would be lower than it is at the moment.
	Earlier in the debate, a number of hon. Members wandered down memory lane and exhumed unhappy incidents in the Conservative party's past. I am not sure whether the House is at its best when it engages in such exercises. Despite the incidents that have been shared by hon. Members on both sides of the House, I do not take the view that Ministers in this Government are basically sleazy, anymore than the Major Government were. The Minister was on rather thin ice when he tried to claim some moral superiority for this Administration.
	Fallibility is politically neutral. One or two individuals in both parties have made mistakes and paid a price. That has not infected the integrity of the political process in this country. By any international or historical standards, the integrity of the process of government in this country is remarkably high. We have a vigilant and at times over-intrusive press, a basically apolitical civil service, a fairly transparent decision-making process and an effective system of parliamentary accountability through Select Committees. As a result, there is a very high chance indeed that any irregularity will come to light, and when it does, that judgment can be swift and harsh.
	I agree, however, with those hon. Members who have said that there is no room for complacency. There is scope for improvement, not least because the perception outside the House is very different from the reality; and in our business, perception is crucial. That is why I welcome this debate on oversight of the ministerial code, which has a role to play in improving the perception, but it will not do so it on its own. In addition to an up-to-date and properly enforced ministerial code, the Government need to take action on party funding and, in particular, to put a cap on large donations, which would, in turn, remove any suspicion that money secures a place in the House of Lords or influences Government policy. We need a civil service Act, for which there is still no timetable, to regulate the interface between the Government and the civil service and, in particular, to clarify the role of special advisers.
	You have indicated, Mr. Deputy Speaker, that you do not want a digression into the Meyer memoirs, but paragraphs 9.17 and 9.18 of the ministerial code deal with the publication of ministerial memoirs. All that I would say in passing is that, if Lord Armstrong and Lord Butler are correct when they assert that the relationship between Ministers and civil servants is threatened if memoirs break confidences, that is true irrespective of whether the confidence is broken by one side or the other. There is a strong argument for a level playing field because at the moment people see Ministers publishing their memoirs without any consequences, but if a civil servant does that, having apparently gone through the requisite procedures, he is criticised without restraint by the Foreign Secretary on the "Today" programme. The rules should be consistently drafted and applied right across the board, but that does not seem to be the case at the moment.
	I want to devote the substance of my brief remarks to comparing the enforcement of the code with which we are all familiar—the code for Members of Parliament, which was revised in July—with that for Ministers to determine whether we can learn from each other. Both codes have the common purpose of promoting high standards of conduct in public life, but they have important differences. One is the property of the House, while the other is the personal property of the Prime Minister—we enforce ours and he enforces his. That reflects the different lines of accountability: that of Ministers to the Prime Minister for their appointment and, indeed, survival, and ours to our electorate through the House.
	There are differences, however. Members have security of tenure and a complaint against a Member usually does not precipitate a collapse in confidence in him or her. Allegations against Ministers are slightly different because collective responsibility means that they have the potential of spreading to the Government as a whole, which risks a more generalised crisis of confidence.
	There are two key procedural differences. First, the House has built its procedures around a strong independent component: the Parliamentary Commissioner for Standards. His report is always published alongside that of the Select Committee on Standards and Privileges, and if the Committee disagrees with him, it must say so and explain why. The fact that that strong independent element is built into our system enhances the credibility and integrity of our self-disciplinary procedures. The second difference is that we have clear rules and procedures on how our system works. For those who are interested, they are available in detail on the Parliamentary Commissioner's website. Neither of those two key features is present in the ministerial code, which weakens its impact and credibility.
	Taking the second point first, the enforcement of the ministerial code is shrouded in secrecy. In the polite language of the Library brief on today's debate:
	"the Code is silent on the means by which allegations should be investigated."
	Indeed, paragraph 4.77 of the Neill report says:
	"In our view, while the Parliamentary route is well-defined by established procedures, the procedure for holding Ministers to account by the public is less clear".
	The follow-up report in 2003 of the Committee on Standards in Public Life advocated mechanisms for investigating alleged misconduct by Ministers, which brings me to the second difference between the codes: the lack of an independent element.
	In the 1997 Parliament, I had reason to believe that a junior Foreign Office Minister had broken the code, so I wrote to the Prime Minister, as custodian of his code. He did not investigate the matter, but passed the letter to Robin Cook, the then Foreign Secretary, who exonerated his colleague of any breach. We need not debate now whether there was a breach of the code, but what cannot be right is the process. The Prime Minister played no part in seeing whether his code had been observed. That was sub-contracted not to an independent observer, but to the Cabinet Minister of the Department in which the alleged breach took place. When I gave evidence to the Neill Committee, it shared my concern about what I called the circularity of the procedure.
	The new code that was published in July does not address either of those two weaknesses. It rejects the recommendations on an independent element that were made by what had by then become the Wicks committee, and there is no clarity on procedure. There has been minor drafting amendment to allow for the possibility of external advice on Ministers' private interests, but the Government rejected the recommendation that two or three senior individuals should be appointed at the beginning of each Parliament to be available to investigate allegations of ministerial misconduct.
	One advantage of having clear and well-publicised procedures for handling complaints against MPs is that when questions about Members arise, they can be considered in a way that takes them—at least temporarily—out of the party political arena. If similar processes could be established in the ministerial area, it would be to the advantage of all parties as well as to the benefit of the public standing of politics in general.
	Another feature of our own arrangements is the ready availability to Members of impartial advice on their obligations under the code and rules. While permanent secretaries advice their Ministers on obligations under the code, they are not in turn supported by a source of independent advice about tricky cases to which both they and Ministers themselves can turn. The Minister might argue that the propriety and ethics team at the Cabinet Office—a body of men that the hon. Member for Cannock Chase omitted to mention when he described the regulatory field—already performs that function, but I am not sure that it would be seen to be independent.
	The Wicks committee, which has of course now become the Graham committee, has expressed regret at the Government's decision not to proceed with the recommendations. The chairman set out his views in more detail in The Independent on Sunday on 6 November.
	The Government amendment has a welcome element, although they have never explained why they have taken so long to make progress, but the more that I listened to the Minister explain why the Government were rejecting the other recommendation about the independent panel, the less obvious the gap was between what the Government are now doing and what the Graham committee is advocating. The Prime Minister is prepared to draw on independent people in certain cases to investigate, and if so, what is the difficulty about the recommendation? I have high hopes that the new head of the civil service will apply his mind to those issues, and I am sure that the Public Administration Committee will want to review the matter.
	I end on the point that independence and clarity are key features of the system of holding Ministers and Members to account. The system that the House has developed for its own procedures has that element of independence and clarity. I do not think that the ministerial code does so, and for that reason I hope that it may be further amended.

Oliver Heald: We have had an excellent debate, to which my right hon. Friend the Member for North-West Hampshire (Sir George Young) made a notable contribution. As Chairman of the Standards and Privileges Committee, he is able to bring his experience of many complaints against Members of Parliament and how they have been dealt with, and to compare that regime with what happens with Ministers under the ministerial code. When he asked where confidence would be if nothing had been done—if we had not had the register, the Committee of Standards and Privileges and the other changes—I agreed with his point.
	That contrasted with the point made somewhat unusually by the hon. Member for Cannock Chase (Dr. Wright), who took an establishment view that we should just stop talking about possible breaches of the ministerial code and try to reduce the number of regulators, and everything would be all right. He must accept that there has been a change in culture over recent years, partly to do with the fact that previously Members of Parliament were paid very little and had outside interests, whereas now that is not the case. The public now expect transparency in what we do and to have an independent element of both advice and investigation.
	The Government's amendment and the Minister's speech were—

Oliver Heald: The Minister may say that, but to me he sounded slightly pompous when he said, "Oh well, we can have the independent adviser and we will make an announcement shortly." Surely the public would react to that attitude by saying, "My goodness, can't they just say they'll do it?" The Minister also showed a certain complacency when he appeared to suggest that everything that the Government do is above board and that there was never a problem.
	I began to think about a civil service Bill, on which I initiated a debate last year. Since 1997, the Government have been promising a civil service Bill, and to be fair to the hon. Member for Cannock Chase, he drafted one. I tried to debate such a Bill in the House, and when I managed to do so the Government said that they would be doing something in due course. Yet here we are today—1997 is a long time ago—and we still do not have a civil service Act on the statute book. The question of whether or not we are to have independent mechanisms to make the ministerial code work seems to be going the wrong way.

Oliver Heald: Lord Neill made his recommendation some years ago. The hon. Gentleman may wish to know that since that time hon. Members on the Opposition Front Bench take advice from the Parliamentary Commissioner on these matters, and in recent years there have been no examples of the sort that the hon. Gentleman mentioned. Those who wish to be shadow Chancellor give up interests that might conflict.
	The Prime Minister writes in the forward to the code that he expects Ministers
	"to work within the letter and spirit of the Code",
	but it is clear that Ministers need a little more help. It may be that they find it hard to ask for or accept advice from their senior civil servant. Perhaps the evidence that the Public Administration Committee received from Sir Robin Mountfield shows that senior civil servants also find the present position difficult. The culture is changing from one where people used to resign quite readily to one where they hardly ever do.
	The issues that cause the difficulty are not so much those where there is a clear disaster in the Department or a clear problem resulting from a Minister's work in his duties. The real problems are the cases of actual or perceived conflict of interest. Those are the ones where the new adviser would be most useful, bringing an independent element, available at an early stage, before the Minister acts ill-advisedly. As the hon. Member for Somerton and Frome (Mr. Heath) pointed out in an excellent and measured contribution, what is the point of rules if they are not properly policed and if independent advice is not available?
	It is not good enough to wait until Parliament is asking questions and the media are sniffing about. We need proper advice for Ministers at an early stage. I like the recommendation about the panel of investigators too, for the reasons that my right hon. Friend the Member for North-West Hampshire and others made clear, but the new adviser would be useful to Ministers in a range of ways on questions not just about their own position, but about spouses, relatives and the like. The outside world sees conflicts of interest and expects them to be stopped. Often the Government do not recognise them. Independence is vital in terms of advice and oversight, because often the Prime Minister is not a neutral and disinterested arbiter.
	When the Labour party took £1 million from motor racing and then delayed the ban on tobacco advertising, it was the Prime Minister who was in the front line having to defend that. It seemed like a conflict of interest, but he said:
	"I'm a regular kind of guy",
	and somehow it was not a problem. It was he who wrote the controversial letter in the Mittalgate scandal, asking a foreign Government for a contract for a Labour donor. It seemed like a conflict of interest, but he said no, it was not.
	When Peter Mandelson accepted a loan of £373,000 from the hon. Member for Coventry, North-West (Mr. Robinson) to buy a house in Notting Hill, he was Secretary of State for Trade and Industry and had oversight of inquiries into the hon. Gentleman's business dealings. It seemed like a conflict of interest, but not to the Prime Minister. It must have done to Mr. Mandelson, because he resigned—but not to the Prime Minister, who said he had done nothing wrong. In the Hinduja passport affair, where wealthy brothers donated £1 million to the faith zone of the dome when Peter Mandelson was the Minister, he called the then Minister with responsibility for immigration matters, now the Solicitor-General, the hon. and learned Member for North Warwickshire (Mr. O'Brien), to inquire about their passport applications, which I believe were then granted. It seemed like a conflict of interest. Mr. Mandelson resigned, but the Prime Minister said that he had done nothing wrong.
	Then we come to the right hon. Member for Sheffield, Brightside and shares owned in a company bidding for work in his Department. It seemed like a conflict of interest. The right hon. Gentleman resigned, but the Prime Minister said that he had done nothing wrong, except that there had been a technical breach, and he left office without a stain on his character. On each of those occasions, there was a public perception of a conflict of interest and a Prime Minister in denial. It would be much better if we had a robust and transparent process with an independent element of investigation and advice, which would deter Ministers from sailing too close to the wind and enable them to take independent advice confidentially and without involving their civil servants. The funny thing is that although the Government have agreed to that step, they will not approve the motion.

Jim Murphy: The debate has not been especially long for a variety of reasons, but we have heard some high quality contributions from Back Benchers.
	On the points made by the hon. Member for Somerton and Frome (Mr. Heath), we continually review the ministerial code, which is published after each general election. We take account of suggestions and recommendations from various Committees, including the Public Administration Committee and the Committee on Standards in Public Life. The precedent has been established, and I think that it will continue, because it would be remarkable if that procedure were turned on its head.
	The hon. Gentleman made a fair speech and tried not to sound supercilious, but I remind him that a halo needs to slip only a foot or two to become a noose. It would be interesting to know whether the Liberal Democrats intend to return the £2.4 million dodgy donation from a Swiss bank account in line with his comments this evening.
	Both Opposition and Government Members acknowledge that my hon. Friend the Member for Cannock Chase (Dr. Wright) speaks with an enormous amount of experience and authority—he keeps Front Benchers on both sides of the House on their toes with his analysis and his experience. He has announced the PAC investigation into who regulates the regulators, and we will pay close attention to the evidence and the PAC's recommendations, as we always do and always should do.
	The Cabinet Office has a vested interest, because it is responsible for the better regulation agenda. At least 12 organisations oversee the probity and ethics of the body politic, and the question is whether we need a 13th—my hon. Friend's Committee may make such a recommendation. My hon. Friend is right that enhancing public faith in politicians from all parties and in Governments—this one, the previous one and any future one—will not be achieved by tinkering with the details of the ministerial code. Although the ministerial code will continue to evolve, it is not a silver bullet to maintain public faith in politics. A much wider debate is taking place not only in this country and this Parliament, but across the world about the connection between the elector and the elected, and all Governments and Opposition parties across the world are grappling with it. I think that faith in politics and the political process will be enhanced not by tinkering with the ministerial code but by delivering real improvements in people's lives and then connecting those improvements to decisions that the Government, whom they have elected, have taken in respect of unemployment, the economy and investment in schools. Such improvements will drive up trust and faith in politics and the political process much more than any squabble across the Dispatch Box about independent assessment of business regulation and the ministerial code.
	The right hon. Member for North-West Hampshire (Sir George Young) again demonstrated his enormous experience. We have been helped by the fact that although there were only two Back-Bench speeches they came from the right hon. Gentleman and my hon. Friend the Member for Cannock Chase, both of whom made important and detailed suggestions. Instead of making a knee-jerk response to the right hon. Gentleman, I will reflect on some of the specifics that he mentioned and offer a more considered response. He mentioned the propriety and ethics team in the Cabinet Office. I add my tribute to the work of the men and women in that team. I will not be alone in thinking that we should have heard the right hon. Gentleman's speech delivered from the Front Bench instead of the two speeches that we did hear.
	The hon. Member for Epsom and Ewell (Chris Grayling) started by saying that he did not want to rake over old coals, and then proceeded to do so. Again, he behaved like a copywriter for the Daily Mail or, on a good day, The Mail on Sunday. He was challenged by my hon. Friend the Member for Cannock Chase on the issue of demanding resignations based on ministerial conduct. I am not able to name and shame the hon. Gentleman on specifics, but he generally uses the tried and tested approach of demanding action based on growing concern expressed in the Daily Mail and The Mail on Sunday. That concern gets into those newspapers because he issues a press release demanding action on it, so the concern that he says is growing is one of his own creation.
	For example, the hon. Gentleman wrote to Ministers challenging the use of public funds on a flight by the Prime Minister to Singapore and then on to Riyadh. I imagine that the Prime Minister must have been in Singapore supporting the 2012 Olympic bid, and I know that he was in Riyadh for a very good reason. The response to the allegation is that there are no scheduled flights between Riyadh and Singapore. Once again, an accusation made publicly in the press turns out to be founded on nothing but speculation and tittle-tattle. That is only the latest example of the hon. Gentleman carrying out that sort of activity.
	The hon. Gentleman is right to say that we do not yet have a civil service Act. However, we now have a draft civil service Bill on which we have consulted. In 18 years of Conservative Government, we had neither a Bill nor a consultation. The hon. Gentleman, like others, will have to be a good deal more patient. We have waited 148 years for the draft Bill, and he can wait a little longer.
	In previous years, a debate on Government ethics and ministerial conduct would have taken place in a packed Chamber. It would have been tense and highly charged, with the cut and thrust of a parliamentary event. This evening's debate was attended by perhaps 10 Members, although I am sure that everyone else had important business to attend to.

Jim Murphy: In the hon. Gentleman's winding-up speech, he argued for something that was not even in the motion and had to be clarified from the Labour Back Benches. It is a short motion but he managed to fail to understand what it demanded. He made up a whole speech on an entirely different matter, which did not appear in the motion.
	Opposition Members mentioned complacency but only six Opposition Back Benchers were present this evening. That does not suggest great demand to discuss—or difficulty with—issues of propriety and public service. However, the idea that there is complacency about those matters is wide of the mark. We are clearing up many of the issues that the Conservatives left unresolved in the 1990s. We are the first Government to publish the ministerial code, introduce a Freedom of Information Act and clean up party political funding. It is clear that those measures have helped to increase public trust in politics and will continue to do that.
	Earlier, my hon. Friend the Member for Houghton and Washington, East (Mr. Kemp) asked whether the Opposition would abide by some of rules and regulations that they understandably expect Ministers to obey. The hon. Member for North-East Hertfordshire (Mr. Heald) was silent on the matter. Will he confirm that all members of the shadow Cabinet will voluntarily or collectively adhere to a similar set of principles to those by which Ministers are expected to abide?

Frank Cook: In April this year, I was visited by two young students, who complained about the inequality of funding between their sixth form school and colleges of further education. They were most anxious to make an impact on what they saw as an inequitable position. On seeking my advice, the best I could give them was that they should start up a petition and secure as many signatures as possible to support their cause. That, they have done, but with the general election and summer recess intervening, it has come back to life only now.
	The two students were Linzi Cooper and Emma Lavery, students of Bede college, Billingham and the petition relates to the residents of Billingham and others.
	The petition states:
	That students of Bede College are proud of their OFSTED report, which found that "levels of achievement are high and few students leave the college before completing the course", but that students are anxious at the concerns of Principal Mrs. Miriam Stanton who said, "while current performance is good we are very worried that we can not invest enough in developing our buildings, our equipment and our staff to preserve this for future students".
	The petitioners list five strong bullet points and pray that the Government take account of them and put into action all their claims
	at the earliest possible date.
	And the Petitioners remain, etc.
	To lie upon the Table.

Denis MacShane: Orhan Pamuk is one of the greatest novelists in Europe, if not the world. He is Turkish, a man of Istanbul, where he has lived since he was born 53 years ago. His novels, which many Members of this House will have read, include "Snow" and "My Name Is Red". We are of course delighted that this year's Nobel prize for literature was awarded to our own Harold Pinter, but it is an open secret that Mr. Pamuk might be on his way to Stockholm as a Nobel laureate, had Harold Pinter not won the votes.
	As you know, Mr. Deputy Speaker, I am a long-time supporter of Turkey's ambition to enter the European Union. I have debated on French television with the former French President, Valery Giscard D'Estaing, why he is wrong to oppose Turkey's ambition to join the EU. I have written and spoken here, in Germany and in other European countries to make the case for Turkey.
	A great writer such as Orhan Pamuk is the perfect ambassador for a Turkey that is looking west to Europe—to the culture of Voltaire, Dickens and the Enlightenment, and to the great tradition of writing and reading that separates so much of European history from other cultures and regions. Yet far from celebrating Orhan Pamuk as an ambassador for Turkey—he was awarded the peace prize at the Frankfurt book fair last month, and his books have sold hundreds of thousands of copies in Turkey and can be found in translation everywhere in the world—we have the tragic spectacle of his going on trial and facing a terrible jail sentence. The trial is scheduled to begin on 16 December—in one month's time. If it begins, it will set back considerably Turkey's ambition to join the EU. It will become a show trial such as we have not seen since the darkest days of the Soviet Union. Mr. Pamuk's trial has caused outrage all over Europe. My right hon. Friend the Foreign Secretary and the Minister for Europe have protested against it, and I know that my hon. Friend the Minister responding to this debate will make the Government's position clear tonight.
	So why is this great novelist facing trial and a prison sentence next month? The answer is that he gave an interview to a Swiss newspaper earlier this year, in which he said that a
	"million Armenians and 30,000 Kurds were killed"
	in Turkey in the last century.
	That is an historical fact. He did not use the word "genocide" or seek to attribute blame. The Turkish Government have opened their archives on this sad period in Turkish history and have asked the Armenian Government to do the same—a suggestion that Armenia would be well advised to take up, as this matter must be settled by academic, historical and forensic investigation, rather than ideological name-calling in the Parliaments of Europe and the world.
	Alas, however, there is a section of fundamentalist nationalist jihadis in Turkish politics, the Turkish media and Turkish state administration who reject any notion of discussing the history of Turkish massacres as history, rather than as contemporary politics. They called for Orhan Pamuk to be silenced, and he received so many death threats—a Turkish nationalist version of the fatwa pronounced against Salman Rushdie—that he left Turkey earlier this year. I met him then as a Minister, and invited him to the Foreign Office in April. We had lunch that day with the Turkish ambassador here in London, and we had a conversation as between civilised people about the Armenian deaths of 90 years ago. I urged the Turkish Government to do all that they could to protect Mr. Pamuk. But instead of the Turkish judiciary protecting this man against the death threats that he received, and the vituperative abuse that he received from the Turkish tabloid press, we have the sad sight of an Istanbul public prosecutor launching a prosecution against him, charging him with public denigration of Turkish identity.
	The prosecutor cited—in effect, hid behind—article 301 of the Turkish penal code. This code is supposed to be reformed to bring it into line with Council of Europe and EU norms, as part of Turkey's preparation for negotiations on future EU membership. Alas, we see that a malign fundamentalist state functionary can take words from the code and use them to launch an attack on free speech and freedom of expression that one might expect in a repressive Ba'athist, Islamicist or other dictatorship, but not in a nation whose culture is long and glorious, whose writers and intellectuals have much to bring to Europe, and whose self-confidence as a Turkish nation secure in its identity is in no way under threat from one of its great novelists.
	Let me make it clear that the issue of the Armenian massacres of 90 years ago is not a taboo subject. I was a British delegate at the NATO parliamentary assembly in Copenhagen. This very morning, I heard the Turkish Prime Minister, Mr. Erdogan, discuss the problem in a calm, sensible and matter-of-fact way.
	Last month, a group of scholars in Istanbul held a conference to discuss the Armenian issue. They, too, had to run the gauntlet of court orders trying to ban the event, and were accused in the Turkish equivalent of our tabloid press of being traitors to Turkey. However, the conference had the support of Turkey's Foreign Minister, Abdullah Gul.
	This morning, when he took questions after his excellent speech, I asked Mr. Erdogan about the Orhan Pamuk case. I asked him to make it clear that the Government of Turkey did not support the prosecution against Orhan Pamuk. Mr. Erdogan talked about the separation of powers between the judiciary and the Executive but, much as I am an admirer of Montesquieu, I know of no Government in the world who cannot find a way of not shooting themselves in the foot. The very great damage that the Orhan Pamuk trial would do to Turkey, if it is allowed to go ahead, should give even the most nationalist Turkish MP, prosecutor or judge pause for thought.

Denis MacShane: For Mr. Pamuk, the notion that he should go on trial and then see what the judge decides is rather a miserable option. Although the separation of powers between Executive and judiciary is well known, prosecutions are partly a matter for the state as well as for the prosecuting authorities. The penal code is wholly a matter for the legislature. As I develop my speech, I shall argue that we should not wait to see whether Mr. Pamuk is acquitted or given only a light or suspended sentence. I shall argue that Turkey should seize the opportunity to send a signal to the world that it is firmly on the democratic path, much as my hon. Friend has suggested.
	Let me report to the House what Mr. Erdogan said in response to my intervention this morning. As a former journalist, I noted down his interpreted words carefully. He said:
	"Our hope and desire is that the judicial decision will be in line with the freedom of expression and freedom of thought."
	I welcome that statement from the Prime Minister of Turkey but I would urge him now as a matter of urgency to find ways of suspending or amending article 301 of the penal code before the trial even starts. I plan to attend the trial, and I appeal to all Members of this House, and to fellow parliamentarians in Europe and the other democracies of the world, to show their support for a free Turkey by coming to the trial or otherwise manifesting support for Orhan Pamuk.
	However, friends of Turkey do not want to see a drawn-out trial which, even if it ends with Orhan Pamuk not going to prison, will none the less only damage the good name of Turkey around the world. This is not simply a question of one writer: the editor of the weekly paper Agos, Mr. Hrant Dink, was found guilty by the Istanbul Sisli court and given a suspended six-month sentence for writing an article in which he was said to insult "Turkish identity." However, no one involved in the trial could point to a single sentence that justified this charge. Does Turkey really want to become the new land of Kafka, a latter-day home of Orwell's thought crimes, the kind of country where the Islamicist censorship machine would welcome article 301 of the penal code?
	Even today, the Sabah daily newspaper reported that a prosecutor in Ankara had said that former head of Turkey's respected human rights advisory board, Professor Ibrahim Kaboglu, and his colleague, Professor Baskin Oran, were to charged with "insulting the judiciary" because they published a report saying that Turkey discriminated against people with separate sub-identities.
	I am sorry, but in today's Europe many groups in our different nations feel that they are discriminated against. I do not know whether the human rights professors are correct, but in Europe we defend to the death their right to make their point. Alas, that is not the case in Turkey, where the state prosecutor in Ankara is invoking article 301 to prosecute those two academics, who can face prison sentences if convicted.
	Frankly, I find it hard to believe that I am standing in the House of Commons making a speech about a writer and about journalists and intellectuals in a country that is seeking to become a member state of the EU.
	After my exchange with Prime Minister Erdogan in Copenhagen, I was buttonholed by a Turkish MP. I did not catch his name, but he told me that he thought that his Prime Minister had gone too far in supporting freedom of expression and that Pamuk was guilty of insulting the Turkish nation. I was pretty rough with him. I said that he would not last long in European politics. If every time that someone wanted to discuss a murky episode involving the deaths of many thousands, even hundreds of thousands of people in British or French or German history because of the cruelty or racism of the state, they were accused of insulting the British or French or German nation, all debate would dry up.
	Listening to that Turkish MP, I thought that I was listening to an Islamic fundamentalist from Iran, or a Ba'athist supporter of Saddam Hussein in Iraq, but he was a fellow MP from a country in NATO that hopes to join the European Union. Instead of modernising Turkey, there appear to be many in Turkish politics and the judicial system who want to bring back ultra-nationalism in order to stop Turkey joining the European Union.
	Orhan Pamuk, sitting and writing in that great cradle city of European civilisation, Istanbul, wants tomorrow's Turkey to look west. The men prosecuting him want to revert to pre-Atatürk days and turn Turkey's face to the dark nationalisms and censorship fundamentalisms of Turkey's eastern neighbours. When General de Gaulle, the French President, was suffering intolerable insults and abuse and calls to insurrection and the overthrow of state authority from the writer Jean-Paul Sartre, in the first period of de Gaulle's presidency after 1958, some smart French official found a law that would justify locking up Sartre and stop his inflammatory utterances. De Gaulle said only:
	"France does not arrest Voltaire."
	The idea that Orhan Pamuk will go on trial is an affront to every person in Turkey who wants that great country to modernise, reform, democratise and prepare for a 21st century future as a great Mediterranean civilisation and European nation. The decision of the prosecutor comforts all those anti-Turkish politicians in Europe who want to slam the door shut in Turkey's face almost as soon as the negotiations on EU membership have begun.
	I am grateful to my right hon. Friends the Foreign Secretary and the Minister for Europe and to our excellent ambassador in Ankara, Sir Peter Westmacott, for the clear position that they have taken on this case. I ask my hon. Friend the Minister replying tonight to make progress on the following points. He need not reply directly tonight—I would be happy if he would put a letter in the Library. First, I ask him to write to Olli Rehn, the EU Commissioner responsible for enlargement negotiations, to ask him to consider making a condition of Turkey joining the EU either the removal of article 301 or the introduction of some clear freedom of expression clause that would override the abusive way that that clause has been used.
	Secondly, I ask my hon. Friend to continue—in bilateral governmental meetings with the Turks—to underline the importance that Britain, as expressed by the Commons and the Government, attaches to the charges being dropped. Thirdly, if the trial does go ahead, I ask my hon. Friend to help MPs and others from PEN or British writers' bodies, in conjunction with the excellent human rights department of the FCO, with travel and other costs necessary to attend the trial. Fourthly, I would like the Government, as the current holder of the presidency of the EU, to issue a formal statement expressing concern about the trial and to publish it in leading Turkish newspapers. I hope that my hon. Friend the Minister will also consider placing a statement reflecting his reply to this debate on the FCO website.
	Fifthly, I ask the Government to welcome the concern expressed by Prime Minister Erdogan and Foreign Minister Gul about the decision by state prosecutors to use the article 301 of the penal code for clear censorship purposes, in breach of European values of freedom of expression. Finally, I ask our embassy in Ankara to translate and make available the full Hansard report of tonight's debate to MPs and opinion-formers in Turkey.
	I deeply regret having been obliged to debate this issue on the floor of the House. I am and will remain a supporter of Turkey's bid for full European status, but that can happen only on the basis of freedom of thought, freedom of expression and freedom of publication. Orhan Pamuk is one of the greatest ornaments to the new Turkey that is taking shape. I hope that as he reads this debate and my hon. Friend's reply he will understand that he has friends in the mother of Parliaments. We will stand by him until he and his fellow Turks enjoy the same rights and freedoms that belong to every citizen of the European Union.

Ian Pearson: I congratulate my right hon. Friend the Member for Rotherham (Mr. MacShane) on securing this debate. He is a long-time champion of intellectual freedom, as well as of Turkey's accession to the European Union, and he made a passionate speech.
	I begin by officially placing on record the Government's serious concern about the charges brought against the renowned author, Orhan Pamuk. Our hope, which has also been expressed by the Turkish Foreign Minister, is that Mr. Pamuk will be acquitted at the next hearing on 16 December. I also want to register concern about the recent charges, mentioned by my right hon. Friend, brought against the authors of a report reviewing Turkey's approach towards its minority constituencies. That is a most unwelcome development.
	I was delighted that we were able to open accession negotiations with Turkey on 3 October. That has long been an objective of the Government. We feel strongly that Turkey's prospective accession will be good for the UK, good for the EU and good for Turkey. One of the primary motivations for our policy remains our firm belief that the prospect of EU membership is providing a major impetus for a fundamental transformation of Turkey and, most important, encouraging greater respect for human rights.
	With the prospect of EU membership maintained through the launch of negotiations, I am confident that Turkey's leaders will be able to continue on the path of reform that has brought them so far. I thank my right hon. Friend for this opportunity to focus minds on the task that lies ahead and, by citing the specific example of the charges brought against Orhan Pamuk, for highlighting the fact that we might not expect the transition in Turkey to European standards to proceed entirely smoothly.
	Last year, the December European Council was able to conclude that Turkey
	"sufficiently fulfilled the Copenhagen political criteria"
	due to the remarkable progress that the Turkish Government had made in their decisive and far-reaching reform process. Although it was widely acknowledged that the legislative framework in Turkey was much improved, it was also clear that full and consistent implementation of the reforms introduced would require concerted effort over a number of years.
	The Government are convinced of the Turkish Government's commitment to reform. In response to the publication, on 9 November, of the European Commission's 2005 regular report on Turkey's progress towards accession, the Turkish Foreign Minister said:
	"Our government is determined to implement the reforms, to deepen and strengthen democracy. We know our own deficiencies and we are determined to overcome them in the coming process."
	The Commission report noted that
	"political transition is ongoing in Turkey",
	but also that
	"the pace of change has slowed in 2005 and implementation of the reforms remains uneven".
	The report is clear about the significance of the new Turkish penal code and related pieces of legislation that recently came into force. It says that those
	"should lead to structural changes in the legal system, particularly in the judiciary".
	Of the penal code, it notes that
	"in general, the Code adopts modern European standards in line with criminal law in many European countries",
	but that
	"concerns remain regarding articles which may be used to restrict freedom of expression".
	The UK, like the European Commission, has been concerned that a number of decisions in Turkey, in relation to the expression of non-violent opinion, have led to both prosecutions and convictions. Notable among them were the charges brought against Orhan Pamuk, but also the prosecution on 7 October, mentioned by my right hon. Friend, of the Turkish writer, Hrant Dink, for insulting the Turkish identity, and the recent charges brought against the authors of a report on Turkish policy on minorities.
	I assure my right hon. Friend that, in our presidency, we have raised our concern about the case of Orhan Pamuk with the Turkish Justice Minister, in early September in the margins of the justice and home affairs informal ministerial, and again when Baroness Scotland visited Ankara on 11 November. Our ambassador in Ankara raised the case with the Turkish Foreign Minister last week, and drew his attention to the exchange in the House on 1 November that concluded that further reform would be necessary. Senior Turkish politicians believe that it is inappropriate for them to intervene, given the independence of the judiciary, but they expect the case to be dismissed when it goes to trial. I can confirm that European diplomats will attend the trial scheduled for 16 December.
	Several recent judgments suggest that the judiciary is increasingly acting in accordance with the case law of the European Court of Human Rights. For example, on 24 October, a journalist, Rahmi Yildirim, who was facing trial for insulting the army, was acquitted after the prosecutor said that his article was not designed to insult anyone. International non-governmental organisations have suggested that broad and poor interpretation of the new penal code by the judiciary is, in part, the result of the vague wording of some of its articles.
	The European Commission agrees with that view and has said that it is most concerned about the articles that refer to offences against symbols of the state and its institutions, including article 301, under which Mr. Pamuk has been charged. Although equivalent articles exist in some parts of the EU, it is crucial that the judiciary enacts the legislation as the political Administration intend. The Commission's regular report states:
	"If the code continues to be interpreted in a restrictive manner, then it may need to be amended in order to safeguard freedom of expression in Turkey."
	The Turkish Prime Minister has himself acknowledged that further amendments to the code may be required and that the process of revision may continue for some years.
	The European Commission has also stressed that, in tandem, efforts to train judges, prosecutors and lawyers must be sustained. My right hon. Friend will know that, last year, the UK co-sponsored a project with the Turkish Ministry of Justice to train more than 8,000 judges and prosecutors in European law and human rights. It is encouraging therefore that, perhaps as a direct result of that and similar training programmes, the courts are reported to have referred to the European convention on human rights in 224 judgments since 2004. Clearly, that the judiciary fully understands that the provisions of the convention are of paramount importance. An amendment to the Turkish constitution in May 2004 recognises the supremacy of international instruments over domestic legislation, in effect, binding Turkey to the provisions of the convention, including article 10 on freedom of expression, and providing a means of recourse when poor decisions are made.
	Turkey's human rights record and the functioning of its judiciary will be subject to intense scrutiny during accession negotiations, and advancement in negotiations will be guided by Turkey's progress. The UK and EU will continue to stress to Turkey the need to safeguard freedom of expression and will raise cases, like that of Orhan Pamuk, where strong disparities with EU practice are clearly evident. However, notwithstanding the fact that Turkey must address such shortfalls, we should set them in the wider context of a country where a fundamental transformation is taking place rapidly to embrace enhanced democratisation—a transformation that we might not realistically expect to be achieved overnight or straightforwardly, but a transformation none the less and one of which my right hon. Friend is extremely supportive.
	The reforms of recent years in Turkey have been hugely impressive. They have required great courage on the part of Turkey's political leaders, and the challenge of overseeing their implementation could be tougher still. The Turkish Government will have to work hard to bring about the culture shift required, and they might expect to encounter points of resistance. Again, my right hon. Friend mentioned them in his contribution.
	The Government, however, are of the firm conviction that Turkey's leaders possess the will to see the process of reform through to its successful conclusion. The Turkish Prime Minister has always said that the reforms are first and foremost for the Turkish people themselves. The EU process has always underpinned the process of reform and acted as a spur to it. With the launch of negotiations, Turkey has set a course to follow for the future. I hope that we will all soon look back on events such as the charges facing Mr. Pamuk as the growing pains of a country maturing into a developing democracy.
	Having said that, it is important to recognise the here and now, and the situation that Mr. Pamuk faces. I stress the importance that the Government attach to the points made by my right hon. Friend. Clearly, the UK cannot interfere in the Turkish judicial system, but we do not believe that Mr. Pamuk should be brought before the courts. We will continue to make representations to the Turkish authorities about his case.
	I will gladly write to my right hon. Friend about the specific points that he made in his speech. The Government want to continue to raise our serious concerns about the fact that Mr. Pamuk is being brought before the courts.
	Question put and agreed to.
	Adjourned accordingly at fourteen minutes to Eleven o'clock.